Cargando…

Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population

A novel qualitative point-of-care test of activated matrix metalloproteinase-8 (aMMP-8) using noninvasive oral rinse sampling procedures has been developed for the early detection of collagen breakdown indicating periodontal tissue destruction. The main object of this study was to assess the reliabi...

Descripción completa

Detalles Bibliográficos
Autores principales: Leppilahti, Jussi M., Harjunmaa, Ulla, Järnstedt, Jorma, Mangani, Charles, Hernández, Marcela, Tervahartiala, Taina, Lopez, Rodrigo, Ashorn, Ulla, Ashorn, Per, Gieselmann, Dirk-Rolf, Sorsa, Timo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164346/
https://www.ncbi.nlm.nih.gov/pubmed/30223547
http://dx.doi.org/10.3390/diagnostics8030067
_version_ 1783359578088407040
author Leppilahti, Jussi M.
Harjunmaa, Ulla
Järnstedt, Jorma
Mangani, Charles
Hernández, Marcela
Tervahartiala, Taina
Lopez, Rodrigo
Ashorn, Ulla
Ashorn, Per
Gieselmann, Dirk-Rolf
Sorsa, Timo
author_facet Leppilahti, Jussi M.
Harjunmaa, Ulla
Järnstedt, Jorma
Mangani, Charles
Hernández, Marcela
Tervahartiala, Taina
Lopez, Rodrigo
Ashorn, Ulla
Ashorn, Per
Gieselmann, Dirk-Rolf
Sorsa, Timo
author_sort Leppilahti, Jussi M.
collection PubMed
description A novel qualitative point-of-care test of activated matrix metalloproteinase-8 (aMMP-8) using noninvasive oral rinse sampling procedures has been developed for the early detection of collagen breakdown indicating periodontal tissue destruction. The main object of this study was to assess the reliability of the test in a low-income setting to identify participants with history of periodontal destruction detected as alveolar bone loss (ABL) in radiographs. This cross-sectional study included 486 women who had recently delivered in rural Malawi. The aMMP-8 test and dental panoramic radiographs were taken within 48 h of delivery. The performance of the test in comparison to radiological examinations was tested by following the standards for reporting of diagnostic accuracy studies protocol (STARD) with respective statistical measures and 95% confidence intervals. From the 486 eligible participants, 461 mothers with complete data, aged from 15 to 46 years (mean 24.8, SD 6.0) were included in the analysis. ABL was identified in 116 of 461 participants. There was 56% agreement between the aMMP-8 test results and detected ABL (yes or no) in radiographs. Calculated sensitivity of the test was 80% (72–87%), specificity 48% (43–54%), positive predictive value 34% (31–37%), negative predictive value 88% (83–91%), positive likelihood ratio 1.55 (1.35–1.77), and negative likelihood ratio 0.41(0.28–0.60). The aMMP-8 test sensitivity and negative predictive value to identify the ABL cases were relatively high, but there was additionally a high rate of test-positive results in participants without ABL, especially in young mothers, leading to low overall agreement between the test results and radiological bone loss. Further longitudinal studies are needed to examine if the test positive subjects are in risk of future bone loss before the detectable signs of periodontitis in radiographs.
format Online
Article
Text
id pubmed-6164346
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-61643462018-10-11 Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population Leppilahti, Jussi M. Harjunmaa, Ulla Järnstedt, Jorma Mangani, Charles Hernández, Marcela Tervahartiala, Taina Lopez, Rodrigo Ashorn, Ulla Ashorn, Per Gieselmann, Dirk-Rolf Sorsa, Timo Diagnostics (Basel) Article A novel qualitative point-of-care test of activated matrix metalloproteinase-8 (aMMP-8) using noninvasive oral rinse sampling procedures has been developed for the early detection of collagen breakdown indicating periodontal tissue destruction. The main object of this study was to assess the reliability of the test in a low-income setting to identify participants with history of periodontal destruction detected as alveolar bone loss (ABL) in radiographs. This cross-sectional study included 486 women who had recently delivered in rural Malawi. The aMMP-8 test and dental panoramic radiographs were taken within 48 h of delivery. The performance of the test in comparison to radiological examinations was tested by following the standards for reporting of diagnostic accuracy studies protocol (STARD) with respective statistical measures and 95% confidence intervals. From the 486 eligible participants, 461 mothers with complete data, aged from 15 to 46 years (mean 24.8, SD 6.0) were included in the analysis. ABL was identified in 116 of 461 participants. There was 56% agreement between the aMMP-8 test results and detected ABL (yes or no) in radiographs. Calculated sensitivity of the test was 80% (72–87%), specificity 48% (43–54%), positive predictive value 34% (31–37%), negative predictive value 88% (83–91%), positive likelihood ratio 1.55 (1.35–1.77), and negative likelihood ratio 0.41(0.28–0.60). The aMMP-8 test sensitivity and negative predictive value to identify the ABL cases were relatively high, but there was additionally a high rate of test-positive results in participants without ABL, especially in young mothers, leading to low overall agreement between the test results and radiological bone loss. Further longitudinal studies are needed to examine if the test positive subjects are in risk of future bone loss before the detectable signs of periodontitis in radiographs. MDPI 2018-09-15 /pmc/articles/PMC6164346/ /pubmed/30223547 http://dx.doi.org/10.3390/diagnostics8030067 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Leppilahti, Jussi M.
Harjunmaa, Ulla
Järnstedt, Jorma
Mangani, Charles
Hernández, Marcela
Tervahartiala, Taina
Lopez, Rodrigo
Ashorn, Ulla
Ashorn, Per
Gieselmann, Dirk-Rolf
Sorsa, Timo
Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population
title Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population
title_full Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population
title_fullStr Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population
title_full_unstemmed Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population
title_short Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population
title_sort diagnosis of newly delivered mothers for periodontitis with a novel oral-rinse ammp-8 point-of-care test in a rural malawian population
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164346/
https://www.ncbi.nlm.nih.gov/pubmed/30223547
http://dx.doi.org/10.3390/diagnostics8030067
work_keys_str_mv AT leppilahtijussim diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT harjunmaaulla diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT jarnstedtjorma diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT manganicharles diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT hernandezmarcela diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT tervahartialataina diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT lopezrodrigo diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT ashornulla diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT ashornper diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT gieselmanndirkrolf diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation
AT sorsatimo diagnosisofnewlydeliveredmothersforperiodontitiswithanoveloralrinseammp8pointofcaretestinaruralmalawianpopulation