Sön 3 dec / År 41 / Nr 5 2023

Early Detection of Periodontal Disease for Tooth Loss Prevention

The Biofilms Research Center for Biointerfaces at Malmö University is advancing research within oral biofilms, pharmaceutical design and smart materials at interfaces. An interdisciplinary project at the center looks for very early biomarkers of inflammatory responses as a means of preventing periodontitis and peri-implantitis.

40% of the Swedish population aged over 50 are affected by periodontitis or peri-implantitis. Central to the development of these diseases is the polymicrobial biofilm on the tooth or dental implant surface and the host inflammatory response. In approx. 20% of the cases the diseases lead to tooth loss or loss of implants, due to extensive destruction of the supporting bone.
Many patients at risk are missed since periodontal disease usually is asymptomatic and difficult for oral healthcare professionals to detect. Others are falsely identified as being at risk. The lack of good predictive tests leads to over-treatment, which constitutes a substantial part of the total treatment costs of SEK 10 billion per year. The chronic infections associated with these diseases are also thought to contribute to cardiovascular disease, rheumatoid arthritis and diabetes.
”Since there are many markers of inflammatory diseases that are similar to each other it’s hard to detect the ones relevant to periodontitis and peri-implantitis. Especially at a very early stage when their concentration in the biofilm is very low,” says Professor and Doctor of Dental Surgery Gunnel Svensäter at the Biofilms Research Center for Biointerfaces at Malmö University.
However, there may be hope, since she leads an interdisciplinary project with the aim of finding just these biomarkers.
”We propose that specific patterns of proteolytic enzymes derived from bacteria and host, cytokines and chemokines in gingival biofluid can be utilised as biomarkers for increased risk of severe bone destruction,” she explains.

An Alternative to Antibodies
The project connects micro-biologists with chemists and engineers. Börje Sellergren, Professor in Biomedical Technology at Malmö University, for instance contributes to the project with his deep knowledge of using chemistry to detect disease markers.
”The principle is related to the clinical use of antibodies to detect disease biomarkers. However, antibodies are expensive, difficult to produce and unstable, so we focus therefore on a robust low-cost alternative to this technology,” he comments.
The next step will be to develop prototypes of the diagnostic tools for identifying patients at risk by combining the synthetic antibodies with different sensor technologies.

”The idea is to get a direct measurement of the concentration of markers in the oral cavity. But we are not doing this alone. This is a multidisciplinary effort involving both industrial and academic partners,” Börje Sellergren adds.

New Therapy Investigated
When a product has been developed that is able to identify the relevant biomarkers in patients, the treatment will focus on removing the polymicrobial biofilms from the patients’ teeth or dental implants. And one of the project aims is to find a new method for doing this.
”We don’t want to disclose any details regarding the therapeutic aspects of the project at this stage, but it’s no secret that we want to come up with a therapy that aims at these biomarkers,” Gunnel Svensäter concludes.