Efficacy of MMP-8 Level in Gingival Crevicular Fluid to Predict the Outcome of Nonsurgical Periodontal Treatment: A Systematic Review.

Sarhang Sarwat Gul,Muhammad Sohail Zafar,Ali Abbas Abdulkareem,Muhammad Saad Shaikh,Natheer Hashim Al-Rawi,Faraedon Mostafa Zardawi

doi:10.3390/ijerph19053131

Abstract

Purpose: To explore whether baseline matrix metalloproteinase (MMP)-8 level in gingival crevicular fluid (GCF) (exposure) can predict the outcome (reduction in probing pocket depth (PPD) (outcome)) of nonsurgical periodontal therapy (NSPT) (manual or ultrasonic or both) in patients with periodontitis (population/problem) after 3 months. Methods: Six databases (PubMed, Cochrane library, ProQuest, Ovid, Scopus, EBSCO) were searched for relevant articles published until 30 July 2021. Retrieved articles were passed through a three-phase filtration process on the basis of the eligibility criteria. The primary outcome was the change in PPD after 3 months. Quality of the selected articles was assessed using Cochrane Risk of Bias tool (RoB2) and Risk of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tools. Results: From 1306 articles, five were selected for analysis. The results showed high variations in the level of GCF MMP-8 level at baseline. The average amount of reduction in PPD was 1.20 and 2.30 mm for pockets with initial depth of 4–6 mm and >6 mm, respectively. Conclusion: On the basis of available evidence, it was not possible to reach a consensus on the ability of baseline GCF MMP-8 to forecast the outcome of NSPT. This could have been due to variation in clinical and laboratory techniques used. However, consistency in mean PPD reduction after 3 months was shown.

Highlights

The research question for this review was formulated according to the Population, Exposure, Outcomes (PEO) criteria: “In patients with periodontitis treated with nonsurgical periodontal treatment (P) using either manual or ultrasonic instrumentation or both, is the baseline gingival crevicular fluid (GCF)
matrix metalloproteinase (MMP)-8 level (E) efficient to predict the success/failure (O) of treatment at three months follow-up?” The primary outcome was the change in mean probing pocket depth (PPD) as assessed by a reduction of 1.26 mm and 2.16 mm after 3 months following nonsurgical periodontal therapy (NSPT) [24]
The presentMMP-8 studyin systematically reviewed reporting the efficacy of with NSPT coupled with strict maintenance by oral hygiene measures

Summary

Introduction

Periodontal disease is a multifactorial inflammatory infection initiated as well as progressed by interactions between a dysbiotic biofilm and an aberrant immune response. As a result, supporting periodontal tissues will be permanently lost due to disruption of periodontal tissue homeostasis [1]. Diagnosis of periodontal diseases aims to identify the type, extent, and severity of the disease so that a suitable treatment plan and maintenance care can be implemented [2]. The diagnosis mainly relies on clinical parameters, including bleeding upon probing (BOP), clinical attachment level (CAL), probing pocket depth (PPD), and alveolar bone loss [3,4]

Methods

Results

Conclusion