University of Oulu

Liukkonen, J.; Gürsoy, U.K.; Könönen, E.; Akhi, R.; Salminen, A.; Liljestrand, J.M.; Pradhan-Palikhe, P.; Pietiäinen, M.; Sorsa, T.; Persson, G.R.; Mäntylä, P.; Buhlin, K.; Paju, S.; Sinisalo, J.; Hörkkö, S.; Pussinen, P.J. Immunological and Microbiological Profiling of Cumulative Risk Score for Periodontitis. Diagnostics 2020, 10, 560.

Immunological and microbiological profiling of cumulative risk score for periodontitis

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Author: Liukkonen, Joonas1; Gürsoy, Ulvi K.1; Könönen, Eija1,2;
Organizations: 1Institute of Dentistry, University of Turku, 20100 Turku, Finland
2Oral Health Care, Welfare Division, City of Turku, 20100 Turku, Finland
3Medical Microbiology and Immunology, Research Unit of Biomedicine, University of Oulu, 90100 Oulu, Finland
4Medical Research Center, Oulu University Hospital and University of Oulu, 90100 Oulu, Finland
5Nordlab, Oulu University Hospital, 90100 Oulu, Finland
6Oral and Maxillofacial diseases, University of Helsinki and Helsinki University Hospital, 00100 Helsinki, Finland
7Department of Periodontology, Institute of Odontology, Karolinska Institutet, 12343 Huddinge, Sweden
8Departments of Periodontics and Oral Medicine, University of Washington, Seattle, WA 98101, USA
9Department of Periodontology, University of Bern, 3001 Bern, Switzerland
10Institute of Dentistry, University of Eastern Finland, 70100 Kuopio, Finland
11Oral and Maxillofacial Diseases, Kuopio University Hospital, 70100 Kuopio, Finland
12HUCH Heart and Lung Center, Helsinki University Central Hospital, 00100 Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2020
Publish Date: 2020-12-01


The cumulative risk score (CRS) is a mathematical salivary diagnostic model to define an individual’s risk of having periodontitis. In order to further validate this salivary biomarker, we investigated how periodontal bacteria, lipopolysaccharide (LPS), and systemic and local host immune responses relate to CRS. Subgingival plaque, saliva, and serum samples collected from 445 individuals were used in the analyses. Plaque levels of 28 microbial species, especially those of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella intermedia, and Tannerella forsythia, and serum and salivary levels of IgA and IgG against these five species were determined. Additionally, LPS activity was measured. High CRS associated strongly with all IgA/IgG antibody and LPS levels in saliva, whereas in serum the associations were not that obvious. In the final logistic regression model, the best predictors of high CRS were saliva IgA burden against the five species (OR 7.04, 95% CI 2.25–22.0), IgG burden (3.79, 1.78–8.08), LPS (2.19, 1.38–3.47), and the sum of 17 subgingival Gram-negative species (6.19, 2.10–18.3). CRS is strongly associated with microbial biomarker species of periodontitis and salivary humoral immune responses against them.

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Series: Diagnostics
ISSN: 2075-4418
ISSN-E: 2075-4418
ISSN-L: 2075-4418
Volume: 10
Issue: 8
Article number: 560
DOI: 10.3390/diagnostics10080560
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Funding: This work was supported by the Academy of Finland (1266053 to P.J.P.); the Sigrid Juselius Foundation (to P.J.P.); the Helsinki University Central Hospital special government funds (E.V.O.) (TYH2012209 and TKK2012005 to J.S.); the Finnish Medical Society’s Swedish Funds, Einar and Karin Stroems Foundation (to K.B.); the Päivi and Sakari Sohlberg foundation (to P.J.P.); the Finnish Dental Society Apollonia (to P.J.P. and J.L.); and the University of Turku joint research grant fund (to J.L.).
Copyright information: © 2020 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 (