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摘要
Selection Criteria The review was conducted according to methods reported in the "Preferred Reporting Items for Systematic Reviews and Meta analyses," registered at PROSPERO under the number CRD42015017767. Bibliographic databases included LILACS, Pub Med, Science Direct, Scopus, and Web of Science. Articles were excluded in phase 1 if they were studies of (1) reviews, letters, personal opinions, book chapters, and other nonrefereed materials; (2) markers from other biological media; (3) materials from in vitro or in vivo models; (4) markers used for assessments for other than diagnostic value; (5) markers from subjects with genetic or systemic syndromes; or (6) studies focused only on smoking or alcohol use. In phase 2 of the selection process, studies were excluded if they did not measure the extent of periodontal disease, if they used only one of the clinical measurements (either pocket probing depth [PPD] or clinical attachment levels [CALs]), or if they only used other periodontal indices. In addition, studies that did not report sensitivity or specificity or those with information inconsistent with a meta-analysis of the data were excluded. Key Study Factor The studies evaluated were not randomized clinical trials but were observational in nature, examining data obtained from bioassays of saliva collected from subjects with and without periodontal disease in a human population that was well defined according to the classification used by Armitage (2004). Key salivary biomarkers for periodontal disease in humans were related to gold standard methods of measuring PPD and CAL in well-defined subjects. Main Outcome Measure As mentioned, the main outcome measure was periodontal PPD measurement in conjunction with CAL measurements. Studies that did not include data from both measurements were excluded from consideration. Main Results About 905 citations were obtained in phase 1 and 144 were retained after full-text evaluation. A total of 140 studies were excluded in phase 2, including 122 that did not report sensitivity and specificity values and 9 that did not use the combined PPD and CAL, thus, 4 studies were included for full analysis. One biomarker, macrophage inflammatory protein-1 alpha (MIP-1 alpha), had excellent diagnostic accuracy (sensitivity 95% and specificity 93%) and interleukin-1 beta (IL-1 beta) and IL-6 showed acceptable diagnostic values: IL-1 beta sensitivity varied from 54% to 88% and specificity varied from 55% to 100% and IL-6 sensitivity varied from 59% to 88% and specificity varied from 60% to 97%. The meta-analysis forest plot showed that MIP-1 alpha was the best marker evaluated. Conclusions The authors concluded that MIP-1 alpha had high diagnostic capability and excellent accuracy and that biomarkers IL-1 beta and IL-6 had acceptable accuracy. However, they also indicated that the evidence reviewed was too restricted to endorse the use of salivary biomarkers as a diagnostic tool based on the available data and suggested more and larger multicentered studies.
- 出版日期2016-9
- 单位rutgers
