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. 2022 Oct 14;12(10):2485.
doi: 10.3390/diagnostics12102485.

Determination of the Accuracy of Salivary Biomarkers for Periodontal Diagnosis

Hiba Abdullah Mohammed  1   2 , Ali Abbas Abdulkareem  2 , Faraedon Mostafa Zardawi  3   4 , Sarhang Sarwat Gul  3
Affiliations

Determination of the Accuracy of Salivary Biomarkers for Periodontal Diagnosis

Hiba Abdullah Mohammed et al. Diagnostics (Basel). .

Abstract

Background: We aimed to investigate the accuracy of salivary matrix metalloproteinases (MMP)-8 and -9, and tissue inhibitor of metalloproteinase (TIMP)-1 in diagnosing periodontitis and in distinguishing periodontitis stages (S)1 to S3.

Methods: This study was a case-control study that included patients with periodontitis S1 to S3 and subjects with healthy periodontia (controls). Saliva was collected, and then, clinical parameters were recorded, including plaque index, bleeding on probing, probing pocket depth, and clinical attachment level. Diagnosis was confirmed by assessing the alveolar bone level using radiography. Salivary biomarkers were assayed using an enzyme-linked immunosorbent assay.

Results: A total of 45 patients (15 for each stage) and 18 healthy subjects as controls were included. The levels of all salivary biomarkers and clinical parameters were significantly higher in periodontitis subjects than in the controls. The ROC curve showed that MMP-8, MMP-9, TIMP-1, MMP-8/TIMP-1, and MMP-9/TIMP-1 had statistically significant diagnostic accuracy, with areas under the curve (AUCs) of 0.892, 0.844, 0.920, 0.986, and 1.000, respectively, when distinguishing periodontitis from the controls. Similarly, these biomarkers showed significant diagnostic accuracy in the differentiation of S1 periodontitis from the controls (AUC range from 0.902 to 1.000).

Conclusions: This study suggested that salivary biomarkers exhibited high diagnostic accuracy in distinguishing periodontal health from periodontitis in general as well as S1 periodontitis. Furthermore, TIMP-1 could differentiate S1 from S3.

Keywords: biomarkers; matrix metalloproteinases; periodontitis; saliva; tissue inhibitor of metalloproteinases.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study. S: stage.
Figure 2
Figure 2
Comparison of clinical parameters among all groups. (A) Mean plaque index (PI): periodontitis (S1 to S3) groups exhibited significantly higher PI than control group. (B) Mean bleeding on probing (BOP) scores: periodontitis (S1 to S3) groups exhibited significantly higher BOP than control group. (C) Mean probing pocket depth (PPD): periodontitis S3 showed significantly higher PPD than periodontitis S1 group. (D) Mean clinical attachment loss (CAL): periodontitis S3 showed significantly higher CAL than periodontitis S1 and S2 groups. CAL of periodontitis S2 was significantly higher than in periodontitis S1 group. * p < 0.03, ** p < 0.01, *** p < 0.001. S: stage.
Figure 3
Figure 3
ROC curves for different salivary biomarkers. (A) MMP-8, (B) MMP-9, (C) TIMP-1, (D) MMP-8/TIMP-1, and (E) MMP-9/TIMP-1. All biomarkers exhibited high sensitivity in distinguishing periodontal health from periodontitis and periodontitis stage (S)1. No biomarker could differentiate different stages of periodontitis, except TIMP-1, which discriminated S1 from S3.
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