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Abstract Objectives The aim of this study is to examine correlations between different oral rinse matrix metalloproteinase (MMP)‐8 protein species in western blot (WB) analysis, quantitative MMP‐8 measurements, and patient‐related factors. Elevated activated MMP‐8 (aMMP‐8) associate with periodontitis and a diagnostic point‐of‐care technology has been developed based on aMMP‐8. In WB, different MMP‐8 protein species can be analyzed. Relative abundancy of fragmented 20–25 kDa forms in WB has been associated with and reflects MMP‐8 activation and related fragmentation and elevated quantitative aMMP‐8 measurements. Material and Methods A random sample of 192 participants from a periodontal disease screening study was used for this study. Oral rinse samples for biomarker analyses were collected before clinical periodontal examinations. aMMP‐8 immunofluorometric (IFMA) and WB analysis (utilizing the same monoclonal antibody, 8708), polymorphonuclear leukocyte (PMN) elastase activity test and tissue inhibitor of metalloproteinases (TIMP)‐1 ELISA levels were performed from the oral rinse samples. Distinct MMP‐8 protein species were differentiated in the WB analysis. Principal component (PC) analysis was conducted to explore correlation patterns between the different species. Adjusted correlation analysis between the extracted PCs of WB and aMMP‐8 IFMA levels and multilevel regression analysis were conducted to explore if the other periodontal disease‐related biomarkers and clinical surrogate measures and patient‐related factors are co‐variating with the extracted components. Results Distinct correlation patterns between the MMP‐8 protein species were observed. The first four PCs explained 89% of the whole variance in PC analysis. Statistically significant correlation (p

Abstract Objectives Periodontitis is a multifactorial biofilm‐induced inflammatory disease; however, clinical and radiographic information reflects events that have already occurred. aMMP‐8 lateral‐flow chairside or point‐of‐care‐test (POC‐test) results have also come to complement the overall status of the patient's current situation. The current study aimed to clarify the usefulness of aMMP‐8 chairside‐test (aMMP‐8 POCT) results to alert the initial or early periodontitis in adolescents, a potential periodontitis risk group with cut off 20 ng/ml in Stage I periodontitis, according to the current periodontitis classification system. Material and Methods A total of 117 adolescents were aMMP‐8 POC tested for aMMP‐8 levels and examined for the full mouth and were interviewed for questions concerning health behavior. Results Of all 117 participants, N = 38 (32.5%) was aMMP‐8 POCT positive, and N = 34 (29.1%) had at least one 4 mm periodontal deepened pocket; however, only N = 16 (13.7%) had both characteristics. The subclinical stage (N = 47) could not be classified either as gingivitis or Stage I. Of the participants, who did not have any deepened periodontal pockets, 18 tested negative. Conclusions Stage I is preceded by antecedent stages that should be tackled by oral healthcare prevention and personalized treatment modalities by professionals. Elevated (>20 ng/ml), positive aMMP‐8 POCT results can be regarded as initial alarmer such as emerging risk. This should be utilized in the preventive personalized interventions by oral health professionals.

Abstract Objectives This mini review aims to address some possible gaps in periodontal diagnosis in clinical studies particularly involving the oral‐systemic connection with a view to minimize such gaps, and thus improve patient treatment experiences and outcomes. Methods The conventional assessment of periodontitis has traditionally been by clinical and radiographic oral parameters. We reviewed numerous studies published mainly within the past decade, to affirm the oral‐systemic link, the contribution of periodontitis to the inflammatory burden in various systemic diseases and conditions, and the potential role of active matrix metalloproteinase‐8 (aMMP‐8). Results While it is established that periodontal pathogens in dental plaque biofilm are the primary initiating agents in periodontitis, it has become clear from the appraisal of recent studies that the host inflammation, including biomarkers such as aMMP‐8 play a major role, being the driving underlying pathological mechanism in both periodontitis and systemic diseases. Conclusions The apparent limitations of conventional diagnostic tools have led researchers to seek alternative methods of evaluation such as the quantification of biomarkers including aMMP‐8, which can be a bridge between oral/periodontal and systemic diseases; aMMP‐8 can form a mouth‐body connection.

Pre-diabetes and diabetes are strongly associated with periodontal disease (gingivitis and periodontitis), and these conditions are known to upregulate aMMP-8 in inflamed gingiva and oral fluids. Thus, it would be feasible to screen for prediabetes and diabetes at the dental office by chairside tests. Chair-side assessment of HbA1c and a quantitative point-of-care (PoC) active matrix metalloproteinase (aMMP)-8 oral rinse immunotest developed for periodontal diseases, were performed on patients (n = 69) attending a Periodontology University Clinic who fulfilled the criteria for testing according to the screening questionnaire of the Centers for Disease Control and Prevention, USA. Clinical parameters of periodontal disease were also recorded with an automated probe. Twenty seven-point-five percent of the subjects were found with previously unknown hyperglycemia (HbA1c ≥ 5.7%). There was a statistically-significant positive association between the aMMP-8test and prediabetes (p < 0.05, unadjusted and adjusted for BMI and age ≥ 45 years logistic regression models). The dental setting is suitable for opportunistic screening for undiagnosed diabetes and pre-diabetes and point-of-care HbA1c, especially when combined with aMMP-8 assessment by dental professionals, being convenient and effective.