Salivary MMP-9 Levels in Chronic Periodontitis Patients with Type-II Diabetes Mellitus

Abstract

Chronic periodontitis and diabetes mellitus share a two-way relationship, the common factor being the inflammatory-mediated pathway, and various cytokines are released during this inflammatory cascade, one of which being matrix metalloproteinase-9. The aim of this study was to identify whether the levels of matrix metalloproteinase-9 are increased due to type-II diabetes mellitus in chronic periodontitis patients. It was an observational, analytical, case-control study. Thirty subjects were recruited in the test group, who were suffering from type-II diabetes mellitus and chronic periodontitis, and 30 subjects in the control group, who were subjects with chronic periodontitis but systemically healthy. Periodontal parameters, including the plaque score, gingival bleeding index, probing pocket depth and clinical attachment level of the subjects, were measured, saliva samples of all of the subjects were collected and salivary matrix metalloproteinase-9 levels were analyzed by an enzyme-linked immunosorbent assay (ELISA) technique. The statistical analysis was performed using SPSS 24. Overall, the matrix metalloproteinase-9 levels of the diabetic patients with chronic periodontitis were increased almost twofold (156.95 ± 29.80 ng/mL) compared to the levels in the controls (74.96 ± 6.32 ng/mL) (p < 0.001). Similarly, the periodontal parameters were far worse in diabetics with chronic periodontitis compared to the controls. The average gingivitis score for the test subjects was 78.45 ± 8.93%), compared to 29.32 ± 12.96% in the controls (p < 0.001). The mean probing pocket depth for the test group was 5.39 ± 0.60 mm, and, for the control group, it was 4.35 ± 0.31 mm (p < 0.001). For the test subjects, the average clinical attachment level was 5.86 ± 0.58 mm, and it was 4.66 ± 0.32 mm for the controls (p < 0.001). It was ascertained that there is a two-fold increase in the levels of salivary matrix metalloproteinase-9 in the test group compared to the control group. In addition, the level of periodontal apparatus destruction was greater in the test group. This proved that type-II diabetes mellitus influences the levels of matrix metalloproteinase-9 in humans and elevates them, causing further periodontal destruction.

Influence of Advanced Glycation End-Products on Salivary Matrix Metalloproteinase 1 Levels in Chronic Periodontitis Patients with Type II Diabetes Mellitus

“…There were 60 total subjects for this study, with 30 in each of the two groups. This was in comparison to the sample size for a comparable study, in which similar number of participants were recruited in test group and the control group [12].…”

“…A similar study was undertaken in the same population in 2017-18, where levels of MMP-9 were ascertained in human salivary samples [12]. Keeping in account that the target population and types of samples were same for this study, the same sample size was used as in the previously cited study, which was a total of 60 subjects, equally divided into control and test groups.…”

Berry as an adjunct to nonsurgical periodontal therapy: A clinical trial

“…[ 1 2 3 4 ] Poor oral hygiene, irregular dental treatment, diabetes mellitus, smoking, age, medicine, and stress overload all, both separately and jointly, cause the spread of periodontal disease in communities. [ 5 6 7 8 9 10 11 ]…”