Biomarker for Asymptomatic Apical Periodontitis in Gingival Crevicular Fluid: aMMP-8

Abstract

Objectives Asymptomatic apical periodontitis (AAP) is one of the most widespread chronic inflammatory diseases in the field of dental medicine. Active matrix metalloproteinase (aMMP-8) previously demonstrated diagnostic potential as a biomarker for AAP in gingival crevicular fluid (GCF). The aim of this study was to determine the levels and diagnostic accuracy of aMMP-8 in GCF from teeth with AAP.

Materials and Methods In this cross-sectional study, GCF samples were obtained from teeth with AAP (sample group, n = 31) and their contralateral teeth (control group, n = 31). Clinical and cone beam computed tomography (CBCT) parameters were used for the diagnosis and assessment of AAP and the determination of clinically healthy marginal periodontal tissues. One pool GCF sample per tooth was obtained from the whole crevice’s perimeter. aMMP-8 levels were determined by enzyme-linked immunosorbent assay (ELISA).

Statistical Analysis Wilcoxon signed ranks test and Spearman rank correlation coefficient (rs) were used as statistical tools. The significance level was set at p < .05.

Results The two groups demonstrated biomarker levels corresponding to a healthy marginal periodontal tissue. aMMP-8 levels were statistically and significantly higher in the samples collected from teeth with AAP. Lesions with greater volume showed correspondingly larger diameters. No statistically significant correlation between aMMP-8 levels and lesions’ volume or diameter was discovered.

Conclusion GCF composition is modified by AAP only to a minimal extent. Further research is needed to substantiate the utilization of aMMP-8 as a potential biomarker for the diagnosis of the disease as well as to explore its relationship with other biomarkers.

Keywords

asymptomatic apical periodontitis - gingival crevicular fluid - aMMP-8 - enzyme linked immunosorbent assay

Publikationsverlauf

Artikel online veröffentlicht:
12. Mai 2020

• References

• 1 Persoon IF, Özok AR. Definitions and epidemiology of endodontic infections. Curr Oral Health Rep 2017; 4 (04) 278-285
• 2 Graves DT, Oates T, Garlet GP. Review of osteoimmunology and the host response in endodontic and periodontal lesions. J Oral Microbiol 2011; 3 (01) 5304
• 3 Dwyer TG, Torabinejad M. Radiographic and histologic evaluation of the effect of endotoxin on the periapical tissues of the cat. J Endod 1981; 7 (01) 31-35
• 4 Bartold PM, Cantley MD, Haynes DR. Mechanisms and control of pathologic bone loss in periodontitis. Periodontol 2000 2010; 53 (01) 55-69
• 5 Liu YC, Lerner UH, Teng YT. Cytokine responses against periodontal infection: protective and destructive roles. Periodontol 2000 2010; 52 (01) 163-206
• 6 Sagi I. Matrix Metalloproteinase Biology. Hoboken, NJ: Wiley Blackwell; 2015
• 7 Rawlings ND, Waller M, Barrett AJ, Bateman A. MEROPS: the database of proteolytic enzymes, their substrates and inhibitors. Nucleic Acids Res 2014; 42 (Database issue) (D1) D503-D509
• 8 Sorsa T, Tjäderhane L, Salo T. Matrix metalloproteinases (MMPs) in oral diseases. Oral Dis 2004; 10 (06) 311-318
• 9 Sorsa T, Tjäderhane L, Konttinen YT. et al. Matrix metalloproteinases: contribution to pathogenesis, diagnosis and treatment of periodontal inflammation. Ann Med 2006; 38 (05) 306-321
• 10 Salazar MG, Jehmlich N, Murr A. et al. Identification of periodontitis associated changes in the proteome of whole human saliva by mass spectrometric analysis. J Clin Periodontol 2013; 40 (09) 825-832
• 11 Gupta N, Gupta ND, Gupta A, Goyal L, Garg S. The influence of type 2 diabetes mellitus on salivary matrix metalloproteinase-8 levels and periodontal parameters: a study in an Indian population. Eur J Dent 2015; 9 (03) 319-323
• 12 Giannobile WV. Host-response therapeutics for periodontal diseases. J Periodontol 2008; 79 (08) (Suppl) 1592-1600
• 13 Herrera D, Matesanz P, Bascones-Martínez A, Sanz M. Local and systemic antimicrobial therapy in periodontics. J Evid Based Dent Pract 2012; 12 (03) (Suppl) 50-60
• 14 Khiste SV, Ranganath V, Nichani AS, Rajani V. Critical analysis of biomarkers in the current periodontal practice. J Indian Soc Periodontol 2011; 15 (02) 104-110
• 15 Miller CS, Foley JD, Bailey AL. et al. Current developments in salivary diagnostics. Biomarkers Med 2010; 4 (01) 171-189
• 16 Sorsa T, Mäntylä P, Tervahartiala T, Pussinen PJ, Gamonal J, Hernandez M. P activation in diagnostics of periodontitis and systemic inflammation. J Clin Periodontol 2011; 38 (09) 817-819
• 17 Sorsa T, Tervahartiala T, Leppilahti J. et al. Collagenase-2 (MMP-8) as a point-of-care biomarker in periodontitis and cardiovascular diseases. Therapeutic response to non-antimicrobial properties of tetracyclines. Pharmacol Res 2011; 63 (02) 108-113
• 18 Baeza M, Garrido M, Hernández-Ríos P. et al. Diagnostic accuracy for apical and chronic periodontitis biomarkers in gingival crevicular fluid: an exploratory study. J Clin Periodontol 2016; 43 (01) 34-45
• 19 Dezerega A, Madrid S, Mundi V. et al. Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic apical periodontitis and endodontic treatment response. J Inflamm (Lond) 2012; 9 (01) 8
• 20 Belmar MJ, Pabst C, Martínez B, Hernández M. Gelatinolytic activity in gingival crevicular fluid from teeth with periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105 (06) 801-806
• 21 Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Primers 2017; 3 (01) 17038
• 22 Fayad MI, Nair M, Levin MD. et al. AAE and AAOMR joint position statement. J Endod 2011; 37 (02) 274-277
• 23 Fayad MI, Nair M, Levin MD. et al. Special Committee to Revise the Joint AAE/AAOMR Position Statement on Use of CBCT in Endodontics. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120 (04) 508-512
• 24 Park HS, Nam HS, Seo HS, Hwang SJ. Change of periodontal inflammatory indicators through a 4-week weight control intervention including caloric restriction and exercise training in young Koreans: a pilot study. BMC Oral Health 2015; 15 (01) 109
• 25 Burgener B, Ford AR, Situ H. et al. Biologic markers for odontogenic periradicular periodontitis. J Endod 2010; 36 (08) 1307-1310
• 26 Leppilahti JM, Hernández-Ríos PA, Gamonal JA. et al. Matrix metalloproteinases and myeloperoxidase in gingival crevicular fluid provide site-specific diagnostic value for chronic periodontitis. J Clin Periodontol 2014; 41 (04) 348-356
• 27 Buduneli N, Kinane DF. Host-derived diagnostic markers related to soft tissue destruction and bone degradation in periodontitis. J Clin Periodontol 2011; 38 (Suppl 11) 85-105
• 28 Arias-Bujanda N, Regueira-Iglesias A, Alonso-Sampedro M. et al Cytokine thresholds in gingival crevicular fluid with potential diagnosis of chronic periodontitis differentiating by smoking status. Sci Rep 2018; 8 (01) 18003
• 29 Mauramo M, Ramseier AM, Mauramo E. et al. Associations of oral fluid MMP-8 with periodontitis in Swiss adult subjects. Oral Dis 2018; 24 (03) 449-455
• 30 Sorsa T, Gursoy UK, Nwhator S. et al. Analysis of matrix metalloproteinases, especially MMP-8, in gingival creviclular fluid, mouthrinse and saliva for monitoring periodontal diseases. Periodontol 2000 2016; 70 (01) 142-163
• 31 Heikkinen AM, Nwhator SO, Rathnayake N, Mäntylä P, Vatanen P, Sorsa T. Pilot study on oral health status as assessed by an active matrix metalloproteinase-8 chairside mouthrinse test in adolescents. J Periodontol 2016; 87 (01) 36-40
• 32 Heikkinen AM, Raivisto T, Kettunen K. et al. Pilot study on the genetic background of an active matrix metalloproteinase-8 test in Finnish adolescents. J Periodontol 2017; 88 (05) 464-472
• 33 Alassiri S, Parnanen P, Rathnayake N. et al. 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. Dis Markers 2018; 2018: 1306396
• 34 Leppilahti JM, Harjunmaa U, Järnstedt J. et al. Diagnosis of newly delivered mothers for periodontitis with a novel oral-rinse ammp-8 point-of-care test in a rural Malawian population. Diagnostics (Basel) 2018; 8 (03) 67
• 35 Lorenz K, Keller T, Noack B, Freitag A, Netuschil L, Hoffmann T. Evaluation of a novel point-of-care test for active matrix metalloproteinase-8: agreement between qualitative and quantitative measurements and relation to periodontal inflammation. J Periodontal Res 2017; 52 (02) 277-284
• 36 Sorsa T, Gieselmann D, Arweiler NB, Hernández M. A quantitative point-of-care test for periodontal and dental peri-implant diseases. Nat Rev Dis Primers 2017; 3 (01) 17069
• 37 Stashenko P, Yu SM, Wang CY. Kinetics of immune cell and bone resorptive responses to endodontic infections. J Endod 1992; 18 (09) 422-426
• 38 Gomes MS, Blattner TC, Sant’Ana Filho M. et al. Can apical periodontitis modify systemic levels of inflammatory markers? A systematic review and meta-analysis. J Endod 2013; 39 (10) 1205-1217
• 39 Georgiou AC, Crielaard W, Armenis I. de Vries R, van der Waal SV. Apical periodontitis is associated with elevated concentrations of inflammatory mediators in peripheral blood: a systematic review and meta-analysis. J Endod 2019; 45 (11) 1279-1295
• 40 Gomes C, Martinho FC, Barbosa DS. et al. Increased root canal endotoxin levels are associated with chronic apical periodontitis, increased oxidative and nitrosative stress, major depression, severity of depression, and a lowered quality of life. Mol Neurobiol 2018; 55 (04) 2814-2827