DEVELOPMENT OF A PERSONALISED PERIODONTITIS SCORE FOR PATIENT RISK STRATIFICATION AND TRAGETED THERAPY

摘要

The present disclosure concerns the development of personalised periodontitis score to assess the individual level of microbial imbalances in periodontal pockets and/or saliva of a specific individual at a defined stage of treatment, relative to a predicted expected score for the average patient with similar systemic and local medical characteristics and demographic profile. The microbial profile obtained from genetic/genomic information is combined with clinical and demographical information in a mixed-effect model to obtain a predicted value and a standard error for a given set of clinical parameters. The comparison between this predicted average score and the individual patient personalised periodontitis score informs about the relative periodontal disease activity in this site and/or patient and thus allows for the stratification of the local site and/or the patient into risk categories and for the recommendation of targeted patient-specific treatment modalities. Specifically, the invention provides a method for the patient- and site- specific assessment of microbial imbalances in periodontitis comprising the steps of  identification and quantification of bacterial species using genetic workflows in samples obtained from periodontal pockets or saliva;  calculation of a microbial profile based on the quantity of one or several bacterial species associated with periodontitis or a ratio of the quantities of these bacteria;  using a reference database, modelling of the microbial profile as a function of a selection of relevant clinical and demographical parameters;  using a set of clinical and demographical parameters from a patient, calculation of the predicted value of the microbial profile via the aforesaid model;  comparison of the microbial profile between the predicted value and the patient value obtained in the laboratory to assess the relative imbalance of the local microbiome and based on this, recommend a site and/or patient-specific therapy.