Active MMP-8 (aMMP-8) as a Grading and Staging Biomarker in the Periodontitis Classification

TLDR

The study aimed to evaluate whether active matrix metalloproteinase‑8 (aMMP‑8) could be incorporated as a biomarker into the 2018 periodontitis stage/grade classification system. In a cohort of 150 Greek adults, participants underwent a rapid aMMP‑8 point‑of‑care mouthrinse test followed by a full‑mouth clinical examination to assess periodontal status. aMMP‑8 levels were significantly lower in healthy individuals compared to those with advanced periodontitis, showed weaker correlation with plaque than bleeding on probing, proved more resilient to oral hygiene effects, and the mouthrinse test offers a quick adjunctive diagnostic tool that supports the new classification.

Abstract

The aim of this study was to investigate the utility of incorporating active matrix metalloproteinase-8 (aMMP-8) as a biomarker into the new periodontitis classification system (stage/grade) presented in 2018. This study included 150 Greek adults aged 25-78, of whom 74 were men and 76 women. Participants were tested with an aMMP-8 point-of-care mouthrinse test, after which a full-mouth clinical examination was performed to assess their periodontal and oral health. The aMMP-8 levels in mouthrinse were significantly lower among healthy patients compared with patients in more severe periodontitis stages and grades (Kruskal-Wallis test and Dunn-Bonferroni test for pairwise post-hoc comparisons; p < 0.01 and p < 0.05, respectively). Furthermore, aMMP-8 levels were less correlated with plaque levels than bleeding on probing (BOP) (Spearman's rho = 0.269, p < 0.001; Spearman's rho = 0.586, p < 0.001); respectively). Thus, aMMP-8 was more robust to the confounding effects of oral hygiene than traditional periodontal parameter bleeding on probing. The aMMP-8 point-of-care mouthrinse test can be utilized as an adjunctive and preventive diagnostic tool to identify periodontal disease, classified by stage and grade, and ongoing periodontal breakdown chairside in clinical practice in only 5 min. Overall, integrating aMMP-8 into the new periodontitis classification system seems beneficial.