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Capacidade de predição de periodontite de parâmetros químicos habitualmente avaliados na urina tipo II (pH, Pro, Nit, Leu e UBG) : estudo piloto em amostra oral
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Introdução: a cavidade oral é uma fonte importante de patologias, sendo um local de interesse para novos diagnósticos através da saliva. Embora constituída por 99% de água, aproximadamente 1% de moléculas orgânicas e inorgânicas conferem-lhe potencial diagnóstico. A saliva é um meio não invasivo, indolor e de fácil recolha que reflete o estado fisiológico humano, permitindo avaliar o risco de cárie, inflamações gengivais e doenças sistémicas como diabetes ou problemas oncológicos. Contudo, possui limitações nos limiares diagnósticos, falsos positivos e escassa correlação clínica. Por sua vez, as tiras Combur são ferramentas urinárias usadas para triagem rápida através de reações químicas que alteram a cor dos reagentes.
Materiais e métodos: neste projeto, utilizaram-se tiras de análise compostas originalmente por dez parâmetros analíticos. Contudo, como o objetivo se foca em avaliar amostras salivares, foram unicamente considerados e registados os resultados obtidos para os seguintes cinco parâmetros específicos: o pH, as proteínas, os nitritos, os leucócitos e o urobilinogénio.
Objetivo: o propósito foi verificar a capacidade preditiva do estado periodontal através destes parâmetros. As tiras possuem um pH fixo e um tampão que asseguram um ambiente constante e ácido; quando imersas na saliva, as proteínas ligam-se aos marcadores, alterando a cor proporcionalmente à sua concentração. O protocolo requereu jejum de comida, bebida e tabaco durante 60 a 90 minutos antes da colheita, além de um bochecho prévio com água limpa. As tiras foram imersas numa amostra de 10ml de soro e saliva e, após retirar o excesso, os resultados foram avaliados comparando a intensidade cromática com a escala padrão.
Resultados: O modelo aplicado a 438 participantes revelou que apenas os marcadores leucocitários possuem associação significativa com a periodontite. Nitritos, proteinúria, pH e urobilinogénio não demonstraram capacidade preditiva autónoma. O protocolo obteve uma Área Sob a Curva de 0.671, ideal para triagem rápida.
Aim: The oral cavity is a major source of pathologies, making it a site of significant interest for new diagnostics through saliva. Although composed of 99% water, approximately 1% of organic and inorganic molecules provide it with diagnostic potential. Saliva is a non-invasive, painless, and easily collected medium that reflects the human physiological state, allowing for the assessment of the risk of dental caries, gingival inflammation, and systemic diseases such as diabetes or certain oncological conditions. However, it still presents limitations regarding diagnostic thresholds, false positives, and scarce clinical correlation. On the other hand, Combur-Test strips are urinalysis tools widely used for rapid screening through chemical reactions that cause a characteristic color change in the reagents. Materials and Methods: In this project, analysis strips originally composed of ten analytical parameters were used. However, since the objective focuses on evaluating salivary samples, only the results obtained for the following five specific parameters were considered and recorded: pH, proteins, nitrites, leukocytes, and urobilinogen. Objective: The purpose was to verify the predictive capacity of the periodontal status through these parameters. The analysis strips have a fixed pH and a buffer that ensure a constant and acidic environment; when immersed in saliva samples, the proteins present bind to the molecular structures of the markers, altering their color proportionally to the salivary protein concentration. The protocol required fasting from food, drink, and tobacco for 60 to 90 minutes before collection, as well as a prior rinse with pure water. The strips were immersed in a 10ml sample of saline solution and saliva and, after removing the excess, the results were evaluated by comparing the color intensity with the standard scale. Results: The multivariate model applied to the sample of 438 participants revealed that only leukocyte markers have a statistically significant association with periodontite. Nitrites, proteinuria, pH, and urobilinogen did not demonstrate autonomous predictive capacity. Overall, the protocol based on the reagent strips achieved an Area Under the Curve (AUC) of 0.671, ideal for rapid screening.
Aim: The oral cavity is a major source of pathologies, making it a site of significant interest for new diagnostics through saliva. Although composed of 99% water, approximately 1% of organic and inorganic molecules provide it with diagnostic potential. Saliva is a non-invasive, painless, and easily collected medium that reflects the human physiological state, allowing for the assessment of the risk of dental caries, gingival inflammation, and systemic diseases such as diabetes or certain oncological conditions. However, it still presents limitations regarding diagnostic thresholds, false positives, and scarce clinical correlation. On the other hand, Combur-Test strips are urinalysis tools widely used for rapid screening through chemical reactions that cause a characteristic color change in the reagents. Materials and Methods: In this project, analysis strips originally composed of ten analytical parameters were used. However, since the objective focuses on evaluating salivary samples, only the results obtained for the following five specific parameters were considered and recorded: pH, proteins, nitrites, leukocytes, and urobilinogen. Objective: The purpose was to verify the predictive capacity of the periodontal status through these parameters. The analysis strips have a fixed pH and a buffer that ensure a constant and acidic environment; when immersed in saliva samples, the proteins present bind to the molecular structures of the markers, altering their color proportionally to the salivary protein concentration. The protocol required fasting from food, drink, and tobacco for 60 to 90 minutes before collection, as well as a prior rinse with pure water. The strips were immersed in a 10ml sample of saline solution and saliva and, after removing the excess, the results were evaluated by comparing the color intensity with the standard scale. Results: The multivariate model applied to the sample of 438 participants revealed that only leukocyte markers have a statistically significant association with periodontite. Nitrites, proteinuria, pH, and urobilinogen did not demonstrate autonomous predictive capacity. Overall, the protocol based on the reagent strips achieved an Area Under the Curve (AUC) of 0.671, ideal for rapid screening.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Saliva Biomarcadores Combur Periodontite