Clinical Correlates of a Lateral-Flow Immunoassay Oral Risk Indicator

• Localización: Journal of periodontology, ISSN 0022-3492, Nº. 1, 2014, págs. 188-194
• Idioma: inglés
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• Resumen

  • Background: The aim of the present study is to investigate the clinical correlates of a novel lateral-flow immunoassay with bleeding on probing (BOP), oral hygiene, and periodontal probing depth. This report offers a simple, rapid, and highly sensitive tool that addresses two issues important to periodontists: 1) detecting active periodontitis, and 2) predicting chronic periodontitis.

    Methods: Seventy-six of 86 males requiring seminal fluid analysis as part of a separate study were serially recruited into the study. After basic dental and periodontal examination under natural light and with the use of the community periodontal index of treatment needs (CPITN) probe, debris and calculus indices were recorded per participant. Participants were subsequently grouped into �good,� �fair,� and �poor� oral hygiene categories based on a simplified oral hygiene index. BOP was assessed with the ball-ended tip of the probe, and periodontitis was assessed with pocket probing as well as a lateral flow of neutrophil collagenase-2 immunoassay, which measures levels of matrix metalloproteinase-8.

    Results: Neutrophil collagenase-2 immunoassay was 96% sensitive for poor oral hygiene, 95% sensitive for chronic periodontitis (defined as at least two sites with periodontal pockets), and 82.6% sensitive for at least two sites with BOP.

    Conclusion: Neutrophil collagenase-2 immunoassay had a high sensitivity for at least two sites with BOP and two sites with periodontal pockets but a lower relationship for single-site pockets and BOP.

    Current trends in periodontal medicine are changing long-held views about the mouth being a mere mirror of the body. A growing body of evidence suggests a two-way relationship,1-3 yet to be fully understood. With the help of modern diagnostic and investigative procedures, it is now possible to predict the risk of chronic periodontitis (CP) in apparently healthy mouths. These scientific innovations and advances are hastening a change of opinion on traditional prevalence figures for periodontitis. It is now widely believed that CP is much more prevalent than was previously perceived and reported in traditional dental texts.4-6 With increasing evidence of a possible link between oral inflammatory burden and general health, the need to rapidly screen a population in an objective manner has never been greater. Developed in Germany and well researched in other parts of the world,7,8 neutrophil collagenase-2 immunoassay has been used in periodontitis screening with claims about its ability to detect periodontal inflammation ahead of overt clinical signs and symptoms.

    Neutrophil collagenase-2 immunoassay could potentially help in rapid screening of a target population with minimal equipment and expertise. If this tool closely correlates clinical parameters and shows enough sensitivity, it could be easily used in such rapid screening without the fear of missing active periodontal lesions. Neutrophil collagenase-2 immunoassay promises this and even more: neutrophil collagenase-2 immunoassay has not only the ability to detect active periodontitis but, in fact, detects subclinical periodontal inflammation.5 Neutrophil collagenase-2 (matrix metalloproteinase-8 [MMP-8]) concentration has been reported to rise in severe CP, especially in non-smokers,7,8 and affects chronic inflammation in other parts of the body.9 One brand of neutrophil collagenase-2 immunoassay** uses lateral-flow immunoassay to detect and measure levels of active MMP-8, a collagenolytic enzyme whose levels rise ahead of overt signs of CP. Therefore, it estimates past and present experience of CP, as well as the risk of yet-to-be-observed CP.

    If this tool does what it claims, it would be useful for dentists as an alternative to more cumbersome traditional measures involving estimations of clinical attachment loss (AL). However, it would serve another purpose: estimation of oral inflammatory burden when there is no dentist! That means that any target group could be easily screened by their health care provider. Only positive cases would then need additional preventive or curative attention of the oral/dental health care practitioner.

    It was in light of these potential benefits that the present authors proceeded to study the clinical oral/periodontal correlates of this novel neutrophil collagenase-2 immunoassay.