On the diagnostic discrimination ability of mouthrinse and salivary aMMP-8 point-of-care testing regarding periodontal health and disease

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

“…Our findings indicate that the aMMP-8 mouthrinse PoC/chairside test [10,12,[14][15][16][17][18][19][20][21][22][23][24][25][26] can be implemented as the staging and grading biomarker in the new classification system of periodontitis [1]. In this regard, a previous study by Räisänen et al [21] showed that mouthrinse aMMP-8 measurements are better and more precise in identifying periodontal health and disease among adolescents in comparison to saliva aMMP-8 measurements. The same result was repeated and further extended in this study by comparing the aMMP-8 PoC/chairside mouthrinse test to salivary aMMP-8 time-resolved immunofluorometric assay (IFMA) measurements, both methods utilizing the same antibody, among this sample of Greek adults (see Figure 2) [10,27,29].…”

“…A.G. performed a full-mouth clinical examination for each patient to assess their periodontal and oral health, after which each patient's aMMP-8 mouthrinse test result was read. Firstly, aMMP-8 levels in mouthrinse were significantly lower among healthy patients compared with patients in more severe periodontitis stages and grades (Kruskal-Wallis test, p < 0.01; Figure 1), as would be expected from an effective diagnostic tool to classify periodontal health and disease [14][15][16][17][18][19][20][21][22][23][24][25][26]. This result is also in agreement with previous studies that have shown that aMMP-8 predicts very well future periodontal breakdown (positive predictive values range between 81.8%-94.7%) [35].…”

“…Furthermore, active periodontal tissue destruction in progress (i.e., the active phase of periodontal disease) can be identified non-invasively in oral fluids as a pathological elevation of aMMP-8 levels [11][12][13]. Thus, it is no surprise that the aMMP-8 chairside/point-of-care (PoC) oral fluid tests have continuously been successful in identifying active periodontal tissue destruction and active periodontal disease (periodontitis, peri-implantitis, subclinical periodontitis) among adults and adolescents of different ethnic populations [10,12,[14][15][16][17][18][19][20][21][22][23][24][25][26]. Similarly, previous longitudinal studies have shown that aMMP-8 assays with the same antibody can be used for predicting the progression of periodontitis and attachment loss, and monitoring treatment of periodontitis during the maintenance phase [27][28][29][30][31][32][33][34].…”

“…In contrast, IFMA measurements of aMMP-8 levels in saliva offered a less definite classification of periodontal health and disease ( Figure 2). As Räisänen et al [21] suggest, mouthrinse aMMP-8 measurements seem the optimal way of measuring the active periodontal breakdown and risk of the future progression of periodontal disease.…”

“…In contrast, IFMA measurements of aMMP-8 levels in saliva offered a less definite classification of periodontal health and disease ( Figure 2). As Räisänen et al [21] suggest, mouthrinse aMMP-8 measurements seem the optimal way of measuring the active periodontal breakdown and risk of the future progression of periodontal disease. The utility of mouthrinse measurements is based on a simple technique to collect and sample gingival crevicular fluid (GCF) [14,21,53], instead of using more laborious filter papers or micropipettes [54].…”