Human Papillomavirus Detection in Crevicular Fluid and Risk Stratification in Refractory Periodontitis: A Multicenter Cross-Sectional Study

Rebolledo-Cobos, Martha; Herrera-Herrera, Alejandra; Plazas Román, Jaime; Barriga Periñan, Luisa; Carmona Lorduy, Martha

doi:10.15517/6wy7yk89

Authors

Martha Rebolledo-Cobos DDS, Specialist in Stomatology and Oral Surgery, Master in Genetics. Professor, Universidad Metropolitana, Barranquilla, Colombia. GIOUMEB Research Group. Author https://orcid.org/0000-0002-0488-2464
Alejandra Herrera-Herrera DDS, Specialist in Epidemiology, Master in Pharmacology. Professor, Universidad Metropolitana, Barranquilla, Colombia. GIOUMEB Research Group. Author https://orcid.org/0000-0001-5830-5868
Jaime Plazas Román DDS, Specialist in Pediatric Dentistry and Maxillary Orthopedics, Master in Bioinformatics. Professor, School of Dentistry, University of Cartagena, Colombia. GITOUC Research Group. Author https://orcid.org/0000-0002-5040-6899
Luisa Barriga Periñan DDS, Specialist in Applied Statistics, Master in Epidemiology. Professor, School of Dentistry, University of Cartagena, Colombia. GITOUC Research Group. Author https://orcid.org/0000-0002-5226-6850
Martha Carmona Lorduy DDS, Specialist in Stomatology, Master in Education. Professor, School of Dentistry, University of Cartagena, Colombia. GITOUC Research Group. Author https://orcid.org/0000-0003-3066-2219

DOI:

https://doi.org/10.15517/6wy7yk89

Keywords:

Periodontitis; Human papillomavirus; Polymerase chain reaction; Gingival crevicular fluid; Risk assessment; Oral health.

Abstract

Refractory periodontitis affects treatment success rates and may be associated with viral reservoirs in periodontal pockets. Human papillomavirus (HPV) causes direct cytopathic effects on periodontal tissues and may contribute to treatment failure. This study aimed to detect HPV in crevicular fluid and develop a risk stratification tool for patients with refractory periodontitis. A cross-sectional multicenter study was conducted involving 80 patients with refractory periodontitis from two Colombian universities. HPV detection was performed using conventional and real-time duplex PCR in crevicular fluid samples. Sociodemographic and clinical variables were analyzed. Multivariate logistic regression and ROC curve analysis were used to develop and validate a risk prediction score. HPV prevalence was 15% (12/80 patients), with high-risk genotypes identified in 4 cases (33% of HPV-positive). Multivariate analysis revealed oral sex practice as the strongest independent predictor (OR=18.9; 95%CI: 4.2-85.3, p<0.001), followed by female sex (OR=2.8; 95%CI: 0.6-13.1) and age >50 years (OR=4.2; 95%CI: 0.5-35.7). The developed risk score showed excellent discriminative capacity (AUC-ROC=0.85; 95%CI: 0.74-0.96) with 75% sensitivity and 82% specificity at optimal cutoff. HPV detection in crevicular fluid using our validated risk stratification tool may identify patients with refractory periodontitis requiring modified therapeutic approaches. The risk score provides a practical clinical tool for HPV screening in periodontal practice.

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