Active MMP‐8 point‐of‐care (PoC)/chairside enzyme‐test as an adjunctive tool for early and real‐time diagnosis of peri‐implantitis

Abstract

Objective The aim of this study was to investigate the utility of the active matrix metalloproteinase (aMMP‐8)‐point‐of‐care (PoC) test as a quantitative real‐time chair‐side diagnostic tool for peri‐implant diagnosis, as well as assess the potentially developing and ongoing risk relative to the traditional clinical methods. Background Current peri‐implant and periodontal disease diagnoses rely on clinical and radiological examinations. This case‐control study investigated the applicability of aMMP‐8‐PoC immunotest for quantitative real‐time diagnosis and monitoring of dental implants in health and disease. Methods Sixty‐eight patients visiting a specialist clinic for maintenance following dental implant placement underwent assessment of their peri‐implant health. aMMP‐8‐PoC peri‐implant sulcular fluid (PISF) lateral‐flow immunotests were performed using ImplantSafe® technology quantitated by ORALyzer®. In addition, the PISF samples were analyzed for total MMP‐8, calprotectin, and interleukin (IL)‐6 by enzyme‐linked immunosorbent assays (ELISA), aMMP‐8 by western immunoblot, and MMP‐2 and MMP‐9 by gelatin zymography. Results The aMMP‐8‐PoC test promptly recorded and reflected peri‐implant disease, differentiating it clearly from health. X‐ray findings (bone loss > 2 mm), peri‐implant pocket depth ≥ 3 mm, and bleeding on probing were significantly more prevalent among implants positive for the aMMP‐8‐PoC test. aMMP‐8/ORALyzer analysis was more precise in recording disease than total MMP‐8, calprotectin, IL‐6, MMP‐2, and MMP‐9. Conclusions The aMMP‐8‐PoC test can be conveniently implemented to alert for and detect active collagenolysis affecting peri‐implant tissues, both in the early and advanced stages of the disease. Active and fragmented MMP‐8 exhibits a strong and significant association with peri‐implantitis as compared to total MMP‐8 and other biomarkers and can be utilized as the POC/chairside biomarker of choice in the new classification of peri‐implantitis.

Evaluation of Salivary Biomarkers of Periodontal Disease Based on Smoking Status: A Systematic Review

“…The systematic literature review yielded a total of seven papers for analysis. Of these, 213 articles were excluded because smoking status was not reported [ 9 , 13 , 33 ] or because they entailed a topic unrelated to the study question [ 18 , 34 ].…”

“…Among the MMPs, MMP-8 and MMP-9 are in the spotlight as biomarkers for periodontal disease. A kit that can test for MMP-8 in 5 min in an office has been developed [ 13 , 14 ].…”

Active MMP-8 as a Biomarker of Peri-implant Health or Disease

“…These findings are in agreement with previous studies that have shown a direct correlation between active MMP-8 levels and periodontal/peri-implant clinical parameters, 10,13,15,17,18 while this strong correlation was not observed between the levels of the total enzyme (both active and latent forms). 19 As discussed earlier, to maintain periodontal and periimplant health, it is crucial to establish collagen balance. The presence of collagen degradation is not feasible to be detected with clinical examination and radiographs, which are the regular assessments of the peri-implant tissues at the dental settings.…”

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

“…Furthermore, the incorporation of validated biomarkers will improve the diagnostic accuracy and assessment of the stage and grade of the new periodontitis classification system by Tonetti et al [100] and recent data indicate that the aMMP-8 mouthrinse test can provide this capability in periodontitis as well as periimplantitis [21,25,28,101,102]. With this background, we now present a modified new classification table with aMMP-8 implemented as the needed biomarker for periodontitis and peri-implantitis (Table 1).…”

“…This fact is supported by the present data, as the subgroup of participants with aMMP-8 levels above 20 ng/mL demonstrated statistically significant differences in clinical parameters of periodontal and peri-implant diseases when compared to subjects with PerioSafe R -and ImplantSafe R ORALyzer R aMMP-8 values below this threshold. The aMMP-8 PoCT-test values < 20 ng/mL can be regarded as biomarkers of periodontal and peri-implant health [21,25,28,101,102].…”