IADR Abstract Archives
Accuracy of Biomarkers in Gingival Crevicular Fluid and Saliva for the Diagnosis of Periodontitis: A Meta-analysis
Objectives: This study aimed to analyse, using a meta-analytical approach, the diagnostic accuracy of molecular biomarkers in gingival crevicular fluid (GCF) and saliva for the detection of periodontitis in systemically healthy subjects.
Methods: Studies on molecular biomarkers detected in GCF and saliva providing a binary classification table (or sensitivity and specificity values and group sample sizes) in individuals with clinically diagnosed periodontitis were considered eligible. The search was performed using six electronic databases. The methodological quality of studies was assessed through the tool Quality Assessment of Diagnostic Studies. Meta-analyses were performed using the Hierarchical Summary Receiver Operating Characteristic, which adjusts the classification data using random-effects logistic regression.
Results: Meta-analyses were possible for 4 and 5 out of 36 and 32 potential biomarkers identified in GCF and saliva, respectively. In GCF, the estimates of sensitivity and specificity were: for matrix metalloproteinase (MMP) 8, 75.8% and 92.9%; for elastase, 78.3% and 76.1%; for capthesin, 75.2% and 71.0% respectively. The worst values of sensitivity and specificity were for trypsin (69.8% and 68.2%, respectively). In saliva, the highest value of sensitivity for the diagnosis of periodontitis was obtained for interleukin (IL) 1beta (78.7%), followed by MMP8 (72.5%), IL6 and haemoglobin (72.0% for both molecules); the lowest sensitivity value was for MMP9 (70.3%). In terms of specificity estimates, MMP9 had the best result (81.5%), followed by IL1beta (78.0%) and haemoglobin (75.2%); MMP8 had the lowest specificity value (70.5%).
Conclusions: MMP8 and elastase are the most researched GCF biomarkers in the diagnostic accuracy field of periodontitis, while in saliva they are MMP8 and IL1beta. In GCF, MMP8 shows good sensitivity and excellent specificity which results in this molecule being clinically the most useful or effective diagnostic biomarker of periodontitis. In saliva, IL1beta and MMP8 present good sensitivity and specificity and clinically fair effectiveness for the diagnosis of periodontitis.
Methods: Studies on molecular biomarkers detected in GCF and saliva providing a binary classification table (or sensitivity and specificity values and group sample sizes) in individuals with clinically diagnosed periodontitis were considered eligible. The search was performed using six electronic databases. The methodological quality of studies was assessed through the tool Quality Assessment of Diagnostic Studies. Meta-analyses were performed using the Hierarchical Summary Receiver Operating Characteristic, which adjusts the classification data using random-effects logistic regression.
Results: Meta-analyses were possible for 4 and 5 out of 36 and 32 potential biomarkers identified in GCF and saliva, respectively. In GCF, the estimates of sensitivity and specificity were: for matrix metalloproteinase (MMP) 8, 75.8% and 92.9%; for elastase, 78.3% and 76.1%; for capthesin, 75.2% and 71.0% respectively. The worst values of sensitivity and specificity were for trypsin (69.8% and 68.2%, respectively). In saliva, the highest value of sensitivity for the diagnosis of periodontitis was obtained for interleukin (IL) 1beta (78.7%), followed by MMP8 (72.5%), IL6 and haemoglobin (72.0% for both molecules); the lowest sensitivity value was for MMP9 (70.3%). In terms of specificity estimates, MMP9 had the best result (81.5%), followed by IL1beta (78.0%) and haemoglobin (75.2%); MMP8 had the lowest specificity value (70.5%).
Conclusions: MMP8 and elastase are the most researched GCF biomarkers in the diagnostic accuracy field of periodontitis, while in saliva they are MMP8 and IL1beta. In GCF, MMP8 shows good sensitivity and excellent specificity which results in this molecule being clinically the most useful or effective diagnostic biomarker of periodontitis. In saliva, IL1beta and MMP8 present good sensitivity and specificity and clinically fair effectiveness for the diagnosis of periodontitis.