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(Dentists of Helsinki Region Association)","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The aim of this cross-sectional study is to propose an efficient strategy based on biomarkers adjunct with an interview\/questionnaire covering risk factors for periodontitis for the identification of undiagnosed periodontitis by medical professionals. Active matrix metalloproteinase (aMMP)-8 levels in mouthrinse were analyzed by a point-of-care (PoC)\/chairside lateral-flow immunotest, and salivary total MMP-8, total MMP-9 and calprotectin levels were analyzed by enzyme-linked immunosorbent assays (ELISAs) and active MMP-9 by gelatin zymography for 149 Greek patients. Patients underwent a full-mouth oral health examination for diagnosis according to the 2018 classification system of periodontal diseases. In addition, patient characteristics (risk factors: age, gender, education level, smoking and body mass index) were recorded. Receiver operating curve (ROC) analysis indicated better diagnostic precision to identify undiagnosed periodontitis for oral fluid biomarkers in adjunct with an interview\/questionnaire compared with a plain questionnaire (i.e., risk factors): aMMP-8 AUC (95% confidence interval) = 0.834 (0.761\u22120.906), total MMP-8 = 0.800 (0.722\u20130.878), active MMP-9 = 0.787 (0.704\u20130.870), total MMP-9 = 0.773 (0.687\u22120.858) and calprotectin = 0.773 (0.687\u20130.858) vs. questionnaire = 0.764 (0.676\u20130.851). The findings of this study suggest that oral fluid biomarker analysis, such as a rapid aMMP-8 PoC immunotest, could be used as an adjunct to an interview\/questionnaire to improve the precision of timely identification of asymptomatic, undiagnosed periodontitis patients by medical professionals. This strategy appears to be viable for referring patients to a dentist for diagnosis and treatment need assessment.<\/jats:p>","DOI":"10.3390\/diagnostics11040711","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T21:35:13Z","timestamp":1618522513000},"page":"711","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["An aMMP-8 Point-of-Care and Questionnaire Based Real-Time Diagnostic Toolkit for Medical Practitioners"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5821-5299","authenticated-orcid":false,"given":"Ismo T.","family":"R\u00e4is\u00e4nen","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7914-9726","authenticated-orcid":false,"given":"Hanna","family":"L\u00e4hteenm\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shipra","family":"Gupta","sequence":"additional","affiliation":[{"name":"Unit of Periodontology, Oral Health Sciences Centre, Post Graduate Institute of Medical Education &amp; Research (PGIMER), Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5542-2230","authenticated-orcid":false,"given":"Andreas","family":"Grigoriadis","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"424 General Military Training Hospital, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6757-8654","authenticated-orcid":false,"given":"Vaibhav","family":"Sahni","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences &amp; Hospital, Panjab University, Chandigarh 160014, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2361-5134","authenticated-orcid":false,"given":"Juho","family":"Suojanen","sequence":"additional","affiliation":[{"name":"Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland"},{"name":"Department of Oral and Maxillo-Facial Surgery, P\u00e4ij\u00e4t-H\u00e4me Joint Authority for Health and Wellbeing, 15850 Lahti, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2529-651X","authenticated-orcid":false,"given":"Hanna","family":"Sepp\u00e4nen","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland"},{"name":"Translational Cancer Medicine Research Program, University of Helsinki, 00014 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8817-896X","authenticated-orcid":false,"given":"Taina","family":"Tervahartiala","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4365-8406","authenticated-orcid":false,"given":"Dimitra","family":"Sakellari","sequence":"additional","affiliation":[{"name":"424 General Military Training Hospital, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Sorsa","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland"},{"name":"Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, 14104 Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2244","DOI":"10.1002\/ijc.31254","article-title":"Periodontitis and cancer mortality: Register-based cohort study of 68,273 adults in 10-year follow-up","volume":"142","author":"But","year":"2018","journal-title":"Int. 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