Abstract
BACKGROUND/PURPOSE: This study evaluates the potential of a novel trypsin-like protease (TLP) measurement device for site-specific periodontal risk assessment, using TLP as a marker for bacterial risk, particularly for Porphyromonas gingivalis (P. gingivalis). MATERIALS AND METHODS: Thirty participants were categorized into three groups: Healthy (n = 10), Perio (untreated periodontitis, n = 9), and Perio-SPC (supportive periodontal care, n = 11). Subgingival plaque samples were collected from the deepest periodontal pocket of the maxillary anterior teeth or single-rooted premolars. TLP activity was measured using the novel device, while P. gingivalis counts, including those of the type II fimA strain, were quantified. Clinical parameters (including probing depth (PD), clinical attachment level, and bleeding on probing) were recorded. Statistical analyses, including Pearson's correlation and receiver operating characteristic (ROC) curve analyses, were performed to evaluate the diagnostic performance of TLP scores. RESULTS: The TLP scores and P. gingivalis counts were significantly higher in the Perio and Perio-SPC groups than in the Healthy group. P. gingivalis type II fimA counts were significantly higher in the Perio group compared with the Healthy group. However, no significant difference was observed between the Healthy and Perio-SPC groups. The TLP scores strongly correlated with PD (rho = 0.80, p < 0.001), total P. gingivalis counts (rho = 0.92, p < 0.001), and P. gingivalis type II fimA counts (rho = 0.73, p < 0.001). Additionally, the ROC analysis showed high accuracy of TLP scores for detecting total P. gingivalis and P. gingivalis type II fimA counts > 10(3)/mL (area under the curve (AUC) = 0.99 and 0.93, respectively). CONCLUSION: The novel TLP measurement system showed potential as a site-specific tool for periodontal risk assessment and monitoring.