Periodontal Initial Radiological Findings of Genetically Predisposed Finnish Adolescents

aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases

The manuscript uses the previously published literature and highlights the benefits of active-matrix metalloproteinase (aMMP)-8 chairside/point-of-care (PoC) diagnostic tools as adjunctive measures in oral and systemic diseases. Previous studies suggest that as a biomarker, aMMP-8 is more precise than total MMP-8, MMP-9, MMP-2, MMP-3, MMP-13, MMP-7, MMP-1, calprotectin, myeloperoxidase (MPO), human neutrophil elastase (HNE), tissue inhibitor of matrix metalloproteinase (TIMP)-1, and bleeding of probing (BOP). Therefore, aMMP-8 could be implemented as the needed key biomarker for the new disease classification for both periodontitis and peri-implantitis. With a sensitivity to the tune of 75-85% and specificity in the range of 80-90%, lateral flow aMMP-8 PoC testing is comparable to catalytic protease activity assays for aMMP-8. The test can be further applied to estimate the glycemic status of an individual, to ascertain whether a person is at risk for COVID-19, in managing the oral side effects of radiotherapy carried in head and neck cancers, and in selected cases pertaining to reproductive health. In the future, aMMP-8 could find application as a potential systemic biomarker in diseases affecting the cardiovascular system, cancers, bacteremia, sepsis, diabetes, obesity, meningitis, as well as pancreatitis. The aMMP-8 PoCT is the first practical test in the emerging new dental clinical field, that is, oral clinical chemistry representing oral medicine, clinical chemistry, peri-implantology, and periodontology.

Investigation of active matrix- metaloproteinase-8 (aMMP-8) as a reference parameter for path control in antimicrobial photothermal therapy (aPTT) using a split-mouth design

OBJECTIVES

This retrospective data-collection study aims to explain how the active matrix-metalloproteinase-8-titer (aMMP-titer) influences the immune response of the subject. This is done through monotherapy scaling and root planing (SRP) which is then compared to SRP combined with antimicrobial photothermal therapy (aPTT, Emundo®).

METHODS

Data collection was monocentric, randomized and split-mouth based. A study group of twenty patients with chronic periodontal disease with a periodontal pocket depth (PPD) 4 mm ≤ PPD ≤8 mm, a periodontal screening index (PSI: > 3), and a gingival recession ≤2 mm were selected.A diode laser, manufactured by A.R.C. Laser GmbH, with 810 nm wavelength was used. This device implemented three different light transmission systems for transgingival and intra-gingival irradiation. Power settings between 200 and 300 mW were deployed for 10 s during all treatment steps. The photothermic dye of EmunDo® system (A.R.C. Laser GmbH) was infracyaningreen.The adjuvant effect of the antimicrobial photothermal therapy (aPTT) with EmunDo® in combination with conventional SRP on the teeth 15 and 35 was compared with the results of monotherapy SRP on teeth 25 and 45.

RESULTS

A reduction of the aMMP-8-titer in gingival crevicular fluid (GCF) was observed in both groups (follow up group and control group) after one month. However; the decrease in the follow up group under SRP in combination with aPTT was significantly more pronounced. The periodontal pocket depths was reduced in both treatment groups. The periodontal probing depth (in mm) shows a larger decrease of the periodontal pocket depth within the follow up group (SPR with aPTT) compared with the control group (SRP).

CONCLUSION

The aMMP-8-titer showed differences in both groups prior to and after treatment. Active matrix-metalloproteinase-8 (aMMP-8) as a reference parameter for path control in antimicrobial photothermal therapy (aPTT) seems acceptable.

Active Matrix Metalloproteinase-8 Point-of-Care (PoC)/Chairside Mouthrinse Test vs. Bleeding on Probing in Diagnosing Subclinical Periodontitis in Adolescents

This cross-sectional study compares the effectiveness of an active MMP-8 (aMMP-8) point-of-care (PoC)/chairside mouthrinse test to the conventional bleeding on probing (BOP) (cutoff 20%) test in detecting subclinical periodontitis/pre-periodontitis in Finnish adolescents. The study was carried out at the Kotka Health Center, Finland. A total of 47 adolescents (30 boys/17 girls) aged 15–17 were first tested with the aMMP-8 PoC test, followed by a full-mouth evaluation of clinical parameters of oral health including periodontal, oral mucosal, and caries assessment. A periodontist performed these clinical examinations. The aMMP-8 PoC test result had much stronger association with subclinical periodontitis than the BOP 20% test (2.8–5.3 times stronger in terms of odds ratio). The aMMP-8 PoC test had ≥2 times higher sensitivity than the BOP 20% test with, generally, the same specificity. Further, the aMMP-8 PoC test had generally better accuracy and lower false negative percentages. The aMMP-8 PoC test seemed to be more effective than the conventional BOP test in detecting subclinical periodontitis/pre-periodontitis in adolescents reducing the risk of their undertreatment. However, the sample size may be a limiting factor, and more studies are needed to confirm our results for both adolescents and adults.

Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population

A novel qualitative point-of-care test of activated matrix metalloproteinase-8 (aMMP-8) using noninvasive oral rinse sampling procedures has been developed for the early detection of collagen breakdown indicating periodontal tissue destruction. The main object of this study was to assess the reliability of the test in a low-income setting to identify participants with history of periodontal destruction detected as alveolar bone loss (ABL) in radiographs. This cross-sectional study included 486 women who had recently delivered in rural Malawi. The aMMP-8 test and dental panoramic radiographs were taken within 48 h of delivery. The performance of the test in comparison to radiological examinations was tested by following the standards for reporting of diagnostic accuracy studies protocol (STARD) with respective statistical measures and 95% confidence intervals. From the 486 eligible participants, 461 mothers with complete data, aged from 15 to 46 years (mean 24.8, SD 6.0) were included in the analysis. ABL was identified in 116 of 461 participants. There was 56% agreement between the aMMP-8 test results and detected ABL (yes or no) in radiographs. Calculated sensitivity of the test was 80% (72–87%), specificity 48% (43–54%), positive predictive value 34% (31–37%), negative predictive value 88% (83–91%), positive likelihood ratio 1.55 (1.35–1.77), and negative likelihood ratio 0.41(0.28–0.60). The aMMP-8 test sensitivity and negative predictive value to identify the ABL cases were relatively high, but there was additionally a high rate of test-positive results in participants without ABL, especially in young mothers, leading to low overall agreement between the test results and radiological bone loss. Further longitudinal studies are needed to examine if the test positive subjects are in risk of future bone loss before the detectable signs of periodontitis in radiographs.