Abstract
Periodontitis is a host-mediated bacterial disease that affects the tooth attachment apparatus. Metalloproteinase-8 (MMP-8), a validated biomarker, could aid in clinical diagnosis. This study aimed to evaluate the diagnostic performance of active (a) MMP-8 immunotest versus total (t) MMP-8 ELISA for quantitative real-time diagnosis and assessment of periodontitis severity at the site level. Gingival crevicular fluid (GCF) was sampled from 30 healthy, 42 mild, and 59 severe periodontitis sites from thirty-one volunteers. MMP-8 concentrations were determined by time-resolved immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using the STATA package. Both active and total MMP-8-based methods discriminated among sites according to periodontal diagnosis and severity, with a positive correlation between the two tests (p < 0.001). (a) MMP-8 models showed the best performance in receiver operating characteristic (ROC) curves to discriminate between healthy and periodontitis sites (area under the curve [AUC] = 0.89), while (t) MMP-8 demonstrated a high diagnostic precision in the detection of mild from severe periodontitis sites (AUC ≥ 0.80). The use of (a) MMP-8 and (t) MMP-8 could represent a useful adjunctive tool for periodontitis diagnosis and severity. These results support the applicability of new point-of-care methods in the monitoring of high-risk periodontal patients.
Highlights
Periodontitis is a globally prevalent public health problem that may lead to tooth loss, esthetic and functional impairment, an elevated economic burden, and even higher risk of other noncommunicable diseases, such as diabetes and atherosclerotic events [1]
This study aimed to evaluate the applicability of active matrix metalloproteinase (a) Matrix metalloproteinases (MMPs)-8 immunotest versus total (t) MMP-8 enzyme-linked immunosorbent assay (ELISA) for the quantitative real-time diagnosis and assessment of site severity of periodontitis
Thirty-one participants (13 healthy and 18 patients with periodontitis) took part in the study. Both groups were similar in gender and smoking status (p > 0.05), while age was significantly higher in participants affected by periodontitis, in comparison with the healthy volunteers (54.1 ± 8.5 and 43.7 ± 14.0 years, respectively; p = 0.02)
Summary
Periodontitis is a globally prevalent public health problem that may lead to tooth loss, esthetic and functional impairment, an elevated economic burden, and even higher risk of other noncommunicable diseases, such as diabetes and atherosclerotic events [1]. It enables the destruction of periodontal ligament fibers, alveolar bone, and apical migration of the gingival junctional epithelium, caused by a dysbiotic microflora that triggers complex immunoinflammatory responses [2]. Periodontal diagnosis is based on traditional clinical measurements of clinical attachment loss, gingival probing depth, and radiographic findings that mainly represent past events of tissue destruction, with a low sensitivity to detect periodontitis at early stages. Ideal diagnostic methods to screen susceptible individuals and sites, predict future destruction, and monitor periodontal therapy response are still being sought [3]. Molecular biomarkers may aid in the incipient diagnostic accuracy of periodontitis, and the potential incorporation of valid biomarkers was recently proposed in the last periodontal classification system [2]
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