{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:55:06Z","timestamp":1785938106605,"version":"3.56.0"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82301157"],"award-info":[{"award-number":["82301157"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Limited awareness, clinical barriers, and persistent high prevalence make large\u2010scale detection of periodontitis challenging, creating demand for simple, affordable, and population\u2010level screening strategies outside traditional dental settings. This study evaluates the diagnostic performance of self\u2010test activated matrix metalloproteinase\u20108 (aMMP\u20108) for identifying periodontitis and assesses the feasibility of a fully self\u2010reported screening model compared with models based on quantitative aMMP\u20108 point\u2010of\u2010care test (POCT) results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional diagnostic study, we evaluated the diagnostic performance of three index tests: self\u2010performed or POCT aMMP\u20108 alone on an oral rinse sample, or in combination with a questionnaire. Periodontitis status was determined using radiographic bone loss according to the 2017 classification, as stages III\u2013IV or stages II\u2013IV. Binary logistic regression models were developed using least absolute shrinkage and selection operator regularization and 5\u2010fold cross\u2010validation. Model performance was assessed by area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 566 participants were included, and 41.7% were diagnosed with stages II\u2013IV periodontitis. Both self\u2010test and quantitative aMMP\u20108 results were significantly associated with periodontitis. In univariable models, self\u2010test aMMP\u20108 showed lower AUROC than quantitative results. However, adding questionnaires and demographic factors in multivariable models improved the diagnostic performance of self\u2010test and minimized the gap between the two. The final multivariable models showed comparable performance for self\u2010test aMMP\u20108\u2010based (AUROC\u00a0=\u00a00.955) and quantitative aMMP\u20108\u2010based (AUROC\u00a0=\u00a00.957) models in stages III\u2013IV periodontitis prediction, with similar results for stages II\u2013IV periodontitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study showed that a self\u2010test aMMP\u20108\u2010based multivariable diagnostic model can perform similarly to a quantitative aMMP\u20108 POCT\u2010based one. Once further developed and validated, a fully self\u2010reported diagnostic model can provide a potential tool for periodontitis screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>This study examined whether a simple, self\u2010administered mouth rinse test could aid in identifying individuals with advanced gum disease. Over 550 adults participated, and approximately 42% were found to have severe gum disease. We discovered that the self\u2010test alone was less accurate than a more detailed machine\u2010based quantitative reading. However, when combined with a questionnaire about dental health and basic personal information, the accuracy of detection improved a lot. These combined methods performed well and were similar to using only the machine results. Our results suggest that a simple screening approach, which includes a self\u2010test, a questionnaire, and personal details, could be an inexpensive and easy\u2010to\u2010use tool for community health screenings to identify severe gum disease early. Further research is needed to test this method in various populations and confirm its effectiveness in real\u2010world settings for identifying gum disease and promoting early dental care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70032","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T04:55:04Z","timestamp":1765428904000},"page":"1300-1316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["aMMP\u20108 self\u2010testing and self\u2010administered questionnaires for periodontitis screening: A diagnostic trial in a Chinese population"],"prefix":"10.1002","volume":"97","author":[{"given":"Yu","family":"Xie","sequence":"first","affiliation":[{"name":"Shanghai PerioImplant Innovation Center Institute for Oral Craniofacial and Sensory Research Ninth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"National Clinical Research Center of Oral Diseases and National Center of Stomatology College of Stomatology Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Yu","sequence":"additional","affiliation":[{"name":"Shanghai PerioImplant Innovation Center Institute for Oral Craniofacial and Sensory Research Ninth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"National Clinical Research Center of Oral Diseases and National Center of Stomatology College of Stomatology Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengning","family":"Bi","sequence":"additional","affiliation":[{"name":"Shanghai PerioImplant Innovation Center Institute for Oral Craniofacial and Sensory Research Ninth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"National Clinical Research Center of Oral Diseases and National Center of Stomatology College of Stomatology Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hairui","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai PerioImplant Innovation Center Institute for Oral Craniofacial and Sensory Research Ninth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"National Clinical Research Center of Oral Diseases and National Center of Stomatology College of Stomatology Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai PerioImplant Innovation Center Institute for Oral Craniofacial and Sensory Research Ninth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"National Clinical Research Center of Oral Diseases and National Center of Stomatology College of Stomatology Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Department of Oral Implantology Ninth People's Hospital  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2743-0137","authenticated-orcid":false,"given":"Maurizio S.","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Shanghai PerioImplant Innovation Center Institute for Oral Craniofacial and Sensory Research Ninth People's Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"National Clinical Research Center of Oral Diseases and National Center of Stomatology College of Stomatology Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"European Research Group on Periodontology (ERGOPerio)  Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13396"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12200"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12344"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063186"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.14022"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12238"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.150458"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13022"},{"issue":"3","key":"e_1_2_10_10_1","first-page":"74","article-title":"Aggressive periodontitis: the silent tooth killer","volume":"104","author":"Levin L","year":"2011","journal-title":"Alpha Omegan"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12517"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12569"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.21\u20100469"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13965"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051x.1987.tb01545.x"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12487"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u2010051x.2000.027005308.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1875\u2010595X.1987.tb00465.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051x.1977.tb01879.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13104"},{"key":"e_1_2_10_21_1","first-page":"325","volume-title":"Radiation Protection in Medical Imaging and Radiation Oncology","author":"Rosario M","year":"2015"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2016.07.020"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034520935854"},{"key":"e_1_2_10_24_1","volume-title":"Statistical Brief (Medical Expenditure Panel Survey (US))","author":"Manski R","year":"2023"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13856"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12899"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13202"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13630"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034513505621"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13485"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13455"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2007.070134"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2012.110676"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13484"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.14000"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/jre.12999"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102016\u2010012799"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.14119"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051X.2009.01518.x"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13588"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1975.46.12.748"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.17\u20100721"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.18\u20100006"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01299946"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.3287615"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.70002"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10080562"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11112885"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.14189"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tibtech.2018.05.013"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.21\u20100660"}],"container-title":["Journal of Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jper.70032","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jper.70032","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jper.70032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:00:38Z","timestamp":1783652438000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1002\/jper.70032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,10]]},"references-count":50,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/jper.70032"],"URL":"https:\/\/doi.org\/10.1002\/jper.70032","archive":["Portico"],"relation":{},"ISSN":["0022-3492","1943-3670"],"issn-type":[{"value":"0022-3492","type":"print"},{"value":"1943-3670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,10]]},"assertion":[{"value":"2025-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}