The Ability of Quantitative, Specific, and Sensitive Point-of-Care/Chair-Side Oral Fluid Immunotests for aMMP-8 to Detect Periodontal and Peri-Implant Diseases

Abstract

The analysis of the disease-specific oral and systemic biomarkers in saliva and oral fluids (i.e., mouth rinse, gingival crevicular fluid (GCF), and peri-implantitis fluid (PISF)) is demanding. Several hosts and microbial factors may influence their expression, release, and levels. The type of saliva/oral fluids utilized for the diagnostics affects the analysis. High sensitivity and specificities together with sophisticated methods and techniques are essential for valuable outcome. We describe here recently developed practical, convenient, inexpensive, noninvasive, and quantitative mouth rinse and PISF/GCF/chair-side/point-of-care (PoC) lateral-flow aMMP-8 immunoassays (PerioSafe and ImplantSafe/ORALyser) to detect, predict, and monitor successfully the course, treatment, and prevention of periodontitis and peri-implantitis, respectively. The tests have been independently and successfully validated to differentiate periodontal and peri-implant health and disease in Finland, Germany, Netherland, Sweden, Turkey, Nigeria, Malawi, and USA. The clinical use of salivary/oral fluid biomarkers to identify oral and systemic conditions requires additional studies utilizing these noninvasive screening, diagnostic, and preventive aMMP-8 PoC/chair-side technologies.

Azurocidin in gingival crevicular fluid as a potential biomarker of chronic periodontitis

“…The possible correlation of azurocidin to periodontal condition was not investigated in these studies which have used saliva as a source for biomarkers of periodontal disease. At the present time, according to the literature, only MMP‐8 in saliva has shown substantial validation as a biomarker for periodontitis and is available as a Point‐of‐Care chair‐side test for clinicians . Taken collectively, data from the present study support the further investigation of azurocidin as a biomarker for periodontal disease.…”

Biological response to peri‐implantitis treatment

“…Studies have detected MMP‐8 in saliva and GCF of periodontitis patients and in PICF of PIP patients suggestive that MMP‐8 levels may be useful for diagnostic monitoring of the connective tissue destruction phase of peri‐implant disease. MMP‐8, including targeting its active form, has been reported to represent a valuable target for chairside point‐of‐care testing of oral fluids related to detection of periodontitis, and more recently in PIP; albeit active MMP‐8’s ability to affect treatment decision‐making remains to be fully elucidated and implemented within the global dental profession. Similar to our findings, Wang et al did not observe significant differences in the concentration of MMP‐8 between healthy and PIP individuals, although the literature would support that differences in selection of antibody systems to detect these types of biomolecules can create variation in the levels and outcome measures between health and disease .…”

A point‐of‐care test of active matrix metalloproteinase‐8 predicts triggering receptor expressed on myeloid cells‐1 (TREM‐1) levels in saliva

“…29,30,45 The same person (AMH) performed all the clinical measurements and the collection of saliva samples. 29,39,40,44,46 AMH was unaware of the aMMP-8 PoC test result when performing each clinical examination. One single blue line on the test device indicated a negative test result, and no risk for active periodontal tissue destruction and periodontitis; while two blue lines indicated a positive test result, and an increased risk for active periodontal tissue destruction and periodontitis.…”

“…One single blue line on the test device indicated a negative test result, and no risk for active periodontal tissue destruction and periodontitis; while two blue lines indicated a positive test result, and an increased risk for active periodontal tissue destruction and periodontitis. 33,[44][45][46]48 The inter-assay coefficient of variation (CV)% was 7.3% (n = 28) and the detection limit was 0.08 g/L for the assays in IFMA. 29,39,40,44,46 AMH was unaware of the aMMP-8 PoC test result when performing each clinical examination.…”

“…22,23 Activated matrix metalloproteinase-8 (aMMP-8) is already known as one of the most validated periodontitis biomarkers. 24,29,30,[36][37][38][39][40][41][42][43][44][45][46] Moreover, previously there have been found a moderate positive association/correlation between MMP-8/PGLYRP1 axis and TREM-1 levels among adults, 14 but to the best of authors' knowl-edge, this association hasn't been studied among adolescent subjects before. [24][25][26][27][28][29][30][31][32][33][34][35] This stage can be measured using a point-of-care (PoC) lateral flow collagenase-2 (aMMP-8) immunotest.…”