Active matrix metalloproteinase-8 and interleukin-6 detect periodontal degeneration caused by radiotherapy of head and neck cancer: a pilot study

Figures & data

Figure 1. Distribution of different cancer types in this study

Table 1. Patient characteristics (n = 11)

Age, years mean (SD); (min–max)	53.1 (15.3); (28–74)
Gender n (%)
Females	1 (9.1)
Males	10 (90.9)
Systemic diseases n (%)
Systemically Healthy	6 (54.5)
Type II diabetes	2 (18.2)
Chronic obstructive pulmonary disease	2 (18.2)
Hypertension	1 (9.1)
Cardiovascular diseases	1 (9.1)
Hypothyroidism	1 (9.1)
Medication n (%)
No medication	6 (54.5)
Metformin HCL	2 (18.2)
Ipratropium bromide	2 (18.2)
Levothyroxine Sodium	1 (9.1)
Anticoagulant (ASA 300 mg)	1 (9.1)
Antihypertensive (Metoprolol)	1 (9.1)
Number of teeth mean (SD); (min–max)
Maxilla & mandible	21.6 (5.0); (14–28)
Maxilla	9.5 (4.2); (0–14)*
Mandible	12.1 (3.1); (5–16)
Stage of periodontitis n (%)
Stage I	0 (0.0)
Stage II	5 (45.4)
Stage III	2 (18.2)
Stage IV	4 (36.4)
Total radiotherapy dose (cGy) mean (SD); (min–max)	6686.4 (428.6); (5800–7000)
Chemotherapy n (%) Yes	6 (54.5)
No	5 (45.5)
Change in CAL (mm) between post- and pre-radiotherapy mean (SD); (min–max) Grade of periodontitis n (%)	1.7 (0.2); (1–3)
Grade A	0 (0.0)
Grade B	0 (0.0)
Grade C	11 (100.0)

SD = standard deviation. CAL = clinical attachment loss.

* One patient with an edentulous maxilla.

Table 2. Periodontal parameters when all teeth, maxilla, and mandible were examined pre- and post-radiotherapy (1 month after the radiotherapy). The significance between these two time-points calculated by paired t-test for each parameter

	Time	Variable	n	Mean (SD)	Median	Min	Max	Mean difference [95% CI]	p value
All teeth	Pre-radiotherapy	Furcation involvement	11	0.29 (0.43)	0.10	0.00	1.00	0.06 [(−0.05)–0.17]	0.241
	Post-radiotherapy	Furcation involvement	11	0.23 (0.42)	0.00	0.00	1.09
Maxilla	Pre-radiotherapy	Furcation involvement	9	0.27 (0.46)	0.00	0.00	1.33	−0.06 [(−0.25)–0.12]	0.432
	Post-radiotherapy	Furcation involvement	9	0.33 (0.67)	0.00	0.00	2.00
Mandible	Pre-radiotherapy	Furcation involvement	11	0.28 (0.44)	0.00	0.00	1.00	0.13 [(−0.08)–0.33]	0.199
	Post-radiotherapy	Furcation involvement	11	0.16 (0.36)	0.00	0.00	1.00
All teeth	Pre-radiotherapy	Mobility	11	0.38 (0.52)	0.21	0.00	1.70	−0.10 [(−0.24)–0.04]	0.144
	Post-radiotherapy	Mobility	11	0.48 (0.61)	0.27	0.00	1.85
Maxilla	Pre-radiotherapy	Mobility	10	0.29 (0.56)	0.00	0.00	2.00	−0.07 [(−0.16)–0.02]	0.096
	Post-radiotherapy	Mobility	10	0.37 (0.67)	0.00	0.00	1.85
Mandible	Pre-radiotherapy	Mobility	11	0.43 (0.54)	0.31	0.00	1.71	−0.08 [(−0.24)–0.07]	0.265
	Post-radiotherapy	Mobility	11	0.51 (0.62)	0.31	0.00	1.79
All teeth	Pre-radiotherapy	Clinical attachment loss (mm)	11	2.12 (1.10)	1.74	0.32	3.60	−0.22 [(−0.29)–(−0.16]	<0.001
	Post-radiotherapy	Clinical attachment loss (mm)	11	2.34 (1.14)	1.93	0.43	3.88
Maxilla	Pre-radiotherapy	Clinical attachment loss (mm)	10	1.80 (1.21)	1.51	0.23	3.75	−0.21 [(−0.30)–(−0.11)]	0.001
	Post-radiotherapy	Clinical attachment loss (mm)	10	2.00 (1.28)	1.79	0.32	4.17
Mandible	Pre-radiotherapy	Clinical attachment loss (mm)	11	2.29 (1.05)	2.28	0.39	3.67	−0.23 [(−0.34)–(−0.13)]	0.001
	Post-radiotherapy	Clinical attachment loss (mm)	11	2.52 (1.13)	2.74	0.50	4.07
All teeth	Pre-radiotherapy	Probing depth (mm)	11	3.37 (1.38)	2.75	2.32	6.52	−0.13 [(−0.26]–(−0.01)]	0.043
	Post-radiotherapy	Probing depth (mm)	11	3.50 (1.41)	2.87	2.32	6.61
Maxilla	Pre-radiotherapy	Probing depth (mm)	10	3.17 (1.42)	2.59	2.17	6.22	−0.11 [(−0.29)–0.08]	0.215
	Post-radiotherapy	Probing depth (mm)	10	3.28 (1.54)	2.67	6.36	6.61
Mandible	Pre-radiotherapy	Probing depth (mm)	11	3.44 (1.35)	2.94	2.25	6.64	−0.16 [(−0.28)–(−0.04)]	0.015
	Post-radiotherapy	Probing depth (mm)	11	3.60 (1.31)	3.07	2.51	6.71
All teeth	Pre-radiotherapy	Bleeding on probing (%)	11	54.43 (23.96)	58.93	14.02	91.25	−11.40 [(−17.50)–(−5.30)]	0.002
	Post-radiotherapy	Bleeding on probing (%)	11	65.83 (25.79)	62.50	14.02	98.75
Maxilla	Pre-radiotherapy	Bleeding on probing (%)	10	52.30 (27.84)	53.13	6.82	88.89	−8.77 [(−17.42)–(−0.12)]	0.047
	Post-radiotherapy	Bleeding on probing (%)	10	61.07 (30.32)	60.57	9.09	100.00
Mandible	Pre-radiotherapy	Bleeding on probing (%)	11	55.87 (22.72)	50.00	19.05	92.86	−12.51 [(−17.76)–(−7.23)]	<0.001
	Post-radiotherapy	Bleeding on probing (%)	11	68.38 (23.97)	64.29	17.46	100.00
All teeth	Pre-radiotherapy	Plaque index	11	1.36 (0.65)	1.14	0.62	2.61	−0.02 [(−0.06)–(−0.10)]	0.574
	Post-radiotherapy	Plaque index	11	1.38 (0.66)	1.18	0.58	2.77
Maxilla	Pre-radiotherapy	Plaque index	10	1.08 (0.52)	0.98	0.23	1.97	0.03 [(−0.03)–0.09]	0.343
	Post-radiotherapy	Plaque index	10	1.05 (0.55)	1.00	0.23	2.00
Mandible	Pre-radiotherapy	Plaque index	11	1.46 (0.65)	1.28	0.75	2.61	−0.06 [(−0.19)–0.08]	0.36
	Post-radiotherapy	Plaque index	11	1.52 (0.63)	1.48	0.83	2.77

Figure 2. Mean levels of aMMP-8 (ng/ml) with 95% confidence interval bars for time-points of pre-radiotherapy, at the end of 6 weeks of radiotherapy and one month after radiotherapy. All significant (* p < 0.05) pairwise comparisons from repeated measures ANOVA analysis adjusted for multiple comparisons (the Bonferroni post hoc test) are marked in the figure

Figure 3. Mean levels of IL-6 (pg/ml) with 95% confidence interval bars for time-points of pre-radiotherapy, at the end of 6 weeks of radiotherapy and one month after radiotherapy. No significant pairwise comparisons were found from repeated measures ANOVA analysis adjusted for multiple comparisons (the Bonferroni post hoc test)

Figure 4. Repeated measures correlation (rmcorr) plot for aMMP-8 and IL-6 levels in mouthrinse that were measured pre-radiotherapy, at the end of 6 weeks of radiotherapy and one month after the end of radiotherapy for eleven head and neck cancer patients