Abstract
BackgroundPathologically elevated levels of matrix metalloproteinase-8 (MMP-8) and Lactoferrin in oral fluids have been associated with the presence of gingivitis/periodontitis. This study aimed to assess the origin of MMP-8 and Lactoferrin in periodontitis patients and to identify the degree to which conventional clinical parameters correlate with their presence.MethodsA total of ten periodontitis and ten healthy patients were included in this study. Whole saliva (stimulated and unstimulated), parotid/sublingual glandular fluid and gingival crevicular fluid from pockets and sulci were tested for MMP-8 and Lactoferrin and protein concentrations were quantified using an ELISA assay. Clinical parameters were checked for potential associations with MMP-8 and Lactoferrin levels.ResultsPeriodontal patients presented higher concentrations of MMP-8 and Lactoferrin in pockets than other sources (P = 0.03). Lactoferrin measurement was higher in the parotid compared to sublingual glandular fluid in periodontitis patients (P = 0.03). Increased probing pocket depth was positively correlated with high MMP-8 and Lactoferrin levels.ConclusionsPeriodontal pockets appear to be the major source of active matrix metalloproteinase and Lactoferrin, which also may also enter the oral cavity through the salivary glands. Since clinically healthy sites in periodontitis patients also had elevated biomarker levels, gingival crevicular fluid biomarker testing may be more predictive of future tissue breakdown than conventional clinical parameters.
Highlights
Elevated levels of matrix metalloproteinase-8 (MMP-8) and Lactoferrin in oral fluids have been associated with the presence of gingivitis/periodontitis
The aim of the study was to determine the presence of Activated/active metalloproteinases 8 (aMMP-8) and Lactoferrin in patients newly diagnosed with active chronic periodontal disease, and to determine the different possible sources of these biomarkers (GCF, major salivary glands and/or whole saliva, both stimulated and unstimulated)
One possible explanation of elevated concentrations of aMMP-8 in saliva, well beyond that found in the saliva’s sources, is that through the chewing motion associated with the collection of stimulated saliva, sufficient quantities of aMMP-8-containing gingival crevicular fluid (GCF) may be released into the saliva
Summary
Elevated levels of matrix metalloproteinase-8 (MMP-8) and Lactoferrin in oral fluids have been associated with the presence of gingivitis/periodontitis. Periodontitis is a common inflammatory oral condition induced by certain periodontal bacterial species [1]. These bacteria colonize the non-shedding hard tissue surfaces and when allowed to grow and mature. Clinical findings around tooth with periodontitis and failing implants include marked gingival inflammation, deep pocket formation, and progressive bone loss [4]. As both periodontitis and peri-implantitis have similar inflammatory phenotypes when assessed cross-sectionally, treatment protocols for peri-implantitis were modeled according to those used for periodontitis. The treatment procedures for peri-implantitis are very similar to that of periodontitis, but more intense and often surgery based. It is crucial to recognize early (subclinical) disease activity before its establishment and assess risk for further disease progression with further tissue destruction
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