AUTHOR=Salminen Aino , Kopra K. A. Elisa , Hyvärinen Kati , Paju Susanna , Mäntylä Päivi , Buhlin Kåre , Nieminen Markku S. , Sinisalo Juha , Pussinen Pirkko J. 

TITLE=Quantitative PCR analysis of salivary pathogen burden in periodontitis

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=5

YEAR=2015

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2015.00069

DOI=10.3389/fcimb.2015.00069

ISSN=2235-2988

ABSTRACT=<p>Our aim was to investigate the value of salivary concentrations of four major periodontal pathogens and their combination in diagnostics of periodontitis. The Parogene study included 462 dentate subjects (mean age 62.9 ± 9.2 years) with coronary artery disease (CAD) diagnosis who underwent an extensive clinical and radiographic oral examination. Salivary levels of four major periodontal bacteria were measured by quantitative real-time PCR (qPCR). Median salivary concentrations of <italic>Porphyromonas gingivalis, Tannerella forsythia</italic>, and <italic>Prevotella intermedia</italic>, as well as the sum of the concentrations of the four bacteria, were higher in subjects with moderate to severe periodontitis compared to subjects with no to mild periodontitis. Median salivary <italic>Aggregatibacter actinomycetemcomitans</italic> concentrations did not differ significantly between the subjects with no to mild periodontitis and subjects with moderate to severe periodontitis. In logistic regression analysis adjusted for age, gender, diabetes, and the number of teeth and implants, high salivary concentrations of <italic>P. gingivalis, T. forsythia</italic>, and <italic>P. intermedia</italic> were significantly associated with moderate to severe periodontitis. When looking at different clinical and radiographic parameters of periodontitis, high concentrations of <italic>P. gingivalis</italic> and <italic>T. forsythia</italic> were significantly associated with the number of 4–5 mm periodontal pockets, ≥6 mm pockets, and alveolar bone loss (ABL). High level of <italic>T. forsythia</italic> was associated also with bleeding on probing (BOP). The combination of the four bacteria, i.e., the bacterial burden index, was associated with moderate to severe periodontitis with an odds ratio (OR) of 2.40 (95% CI 1.39–4.13). When <italic>A. actinomycetemcomitans</italic> was excluded from the combination of the bacteria, the OR was improved to 2.61 (95% CI 1.51–4.52). The highest OR 3.59 (95% CI 1.94–6.63) was achieved when <italic>P. intermedia</italic> was further excluded from the combination and only the levels of <italic>P. gingivalis</italic> and <italic>T. forsythia</italic> were used. Salivary diagnostics of periodontitis has potential especially in large-scale population studies and health promotion. The cumulative strategy appears to be useful in the analysis of salivary bacteria as markers of periodontitis.</p>