PDF(Pubmed)
Abstract：
Background/Objectives: Nonsurgical periodontal treatment (NSPT) is the gold-standard technique for treating periodontitis. However, an individual\'s susceptibility or the inadequate removal of subgingival biofilms could lead to unfavorable responses to NSPT. This study aimed to assess the potential of salivary and microbiological biomarkers in predicting the site-specific and whole-mouth outcomes of NSPT. Methods: A total of 68 periodontitis patients exhibiting 1111 periodontal pockets 4 to 6 mm in depth completed the active phase of periodontal treatment. Clinical periodontal parameters, saliva, and subgingival biofilm samples were collected from each patient at baseline and three months after NSPT. A quantitative PCR assay was used to detect the presence of Fusobaterium nucleatum and Porphyromonas gingivalis in the biofilm samples. Salivary biomarkers including matrix metalloproteinase (MMP)-9, glutathione S-transferase (GST), and Annexin-1 were assayed both qualitatively (Western blot analysis) and quantitively (ELISA). Results: NSPT yielded significant improvements in all clinical parameters, including a reduction in bacterial load and decreased levels of MMP-9 together with increased concentrations of GST and Annexin-1. The binary logistic regression suggested that the overall accuracy of P. gingivalis identification, probing pocket depth, and interproximal sites was 71.1% in predicting successful site-specific outcomes. The salivary biomarker model yielded an overall accuracy of 79.4% in predicting whole-mouth outcomes following NSPT. Conclusions: At baseline, the presence of shallow periodontal pockets at interdental locations with a lower abundance of P. gingivalis is predictive of a favorable response to NSPT at the site level. Decreased salivary MMP-9 associated with increased GST and Annexin-1 levels can predict successful whole-mouth outcomes following NSPT.
摘要：
背景/目的：非手术牙周治疗（NSPT）是治疗牙周炎的金标准。然而,个体的易感性或龈下生物膜去除不足可能导致对NSPT的不利反应。这项研究旨在评估唾液和微生物生物标志物在预测NSPT的位点特异性和全口结局方面的潜力。方法：共68例牙周炎患者，牙周袋为1111个，深度为4至6mm，完成了牙周治疗的活动期。临床牙周参数，唾液,在基线和NSPT后三个月从每位患者收集龈下生物膜样品。使用定量PCR测定法来检测生物膜样品中核叶镰刀菌和牙龈卟啉单胞菌的存在。唾液生物标志物包括基质金属蛋白酶（MMP）-9，谷胱甘肽S-转移酶（GST），和膜联蛋白-1进行定性(Western印迹分析)和定量(ELISA)测定。结果：NSPT在所有临床参数方面均有显着改善，包括细菌负荷减少和MMP-9水平降低以及GST和膜联蛋白-1浓度增加。二元逻辑回归表明，牙龈卟啉单胞菌鉴定的总体准确性，探测袋深度,在预测成功的特定部位结局方面，邻间部位为71.1%。唾液生物标志物模型在预测NSPT后的全口结局方面的总体准确性为79.4％。结论：在基线时，牙间位置存在浅牙周袋,牙龈卟啉单胞菌丰度较低,这预示着在该部位水平对NSPT的反应良好.与GST和Annexin-1水平增加相关的唾液MMP-9减少可以预测NSPT后全口结局。
