aMMP-8 point-of-care - diagnostic methods and treatment modalities in periodontitis and peri-implantitis

ABSTRACT

Introduction

When collected in a standardized fashion, oral fluid analysis can refine the diagnosis of periodontal and peri-implant disease. In practice, dental professionals can perform active matrix metalloproteinase (aMMP-8) analysis chairside.

Areas covered

Periodontal tissues are mainly made up of type I collagen, and collagen breakdown is one of the main events in periodontal and peri-implantitis destructive lesions. In addition to traditional measurements, their diagnosis can be refined with tests utilizing oral fluids. The active matrix metalloproteinase-8 (aMMP-8) is possible to be determined from the gingival crevicular fluid (GCF), peri-implant sulcus fluid (PISF), and other oral fluids such as mouth rinse and saliva. We also investigated the applicability of aMMP-8 chair-side test kits in the evaluation of oral health benefits of different adjunctive host-modulating periodontal therapies including fermented lingonberry mouthwash (FLJ) and antibacterial photodynamic therapy (aPDT).

Expert opinion

The aMMP-8 levels can more reliably detect early activation of periodontal and peri-implant disease as compared to traditional diagnostic methods that assess the experienced health status or past disease, rather than the present or future pathology. Novel therapies like, fermented lingonberry juice as a mouthrinse or aPDT, are potential host-modulating adjunctive treatments to reduce the signs of oral inflammation and infection.

KEYWORDS:

• aMMP-8
• periodontitis
• peri-implantitis
• home treatment
• fermented lingonberry juice
• dual-light therapy

Article highlights

• The aMMP-8 PoC/chairside test can be used to predictively detect active and early collagenolysis in periodontal and peri-implant tissues.

• The aMMP-8 PoC/chairside test is far more accurate in diagnosing peri-implantitis and healthy implants than BOP or other potential biomarkers.

• Our recommended risk limits for peri-implantitis diseases are: Low aMMP-8 levels <20 ng/ml in PISF are clearly linked to healthy implants, moderate aMMP-8 levels ≥20 ng/ml to elevated risk of peri-implantitis and high aMMP-8 levels ≥80 ng/ml to enhanced risk and more rapid disease progression.

• Fermented lingonberry juice in daily use reduces the visible signs of inflammation and infection in the oral cavity. FLJ is natural and safe to use as a supplement for oral, periodontal and dental implant home care.

• Dual-light therapy is antibacterial and inflammatory method and reduces VPI, BOP, and aMMP-8 in PISF and oral fluids. It increases oral hygiene levels without any side effects.

Declaration of interest

T Sorsa is the inventor of the following patents: 1274,416-patent U.S. 5,652,223, 5,736,341, 5,864,632, 6,143,476, and US 2017/0023571A1 (issued 6 June 2019); WO 2018/060553 A1 (issued May 31, 201); 10,488,415 B2, Japanese Patent 2016–554676; and South Korean patent 10–2016– 7025378. T Pätilä is a member of the board of Koite Health company. The company has filed patents P21233F100 and P22769F100 and owns trademarks related to antibacterial dual-light, Lumoral®. Koite Health develops, sells, and markets dual-light antibacterial products for the prevention and treatment of dental and periodontal infections. P Pärnänen is the inventor of patent EP 2585087B1 and the holder of the trademark Lingora®.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This article received financial support from research grants from Helsinki and Uusimaa Hospital District (HUS): TYH 2022225, TYH2016251, TYH2017251, TYH2018229, TYH2019319, Y1014SL017, Y1014SL018, Y1014SULE1, the Minerva Foundation Selma and Maja‐Lisa Selander’s Fund; the Yrjö Jahnsson Foundation sr; the Paulo Foundation; the Emil Aaltonen Foundation sr; The biomedicum Helsinki Foundation sr; the Juhani Aho Foundation for Medical Research sr; the Orion Research Foundation and Helsingin Seudun Hammaslääkärit r.y. (Dentists of Helsinki Region Association), Finland.