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.

Figure 1

aMMP-8 chair-side levels analysed visually (+/−) and quantitated for aMMP-8 (ng/ml) by ORALyser reader to monitor the effect of periodontal treatment (scaling and root planing) on chronic periodontitis (n = 10) (a) and healthy controls (n = 10) (b).

Figure 2

Peri-implant sulcular fluid (PISF) collected from 29 peri-implantitis and 32 periodontally healthy sites were tested for elevated aMMP-8 by ImplantSafe PoC/chair-side test (+/−), analysed for aMMP-8 (ng/ml) by immunofluorometric assay (IFMA), and by quantitated gelatin zymography for all molecular weight forms of gelatinase-B (MMP-9, zymographic densitometric units) (a). Implantitis sites were tested before and after surgical treatment by ImplantSafe (+/−); treatment caused positive sites to be negative (b). Elevated aMMP-8 levels in PISF detected by ImplantSafe positivity and IFMA associated significantly with peri-implantitis (p < 0.0001, Wilcoxon test (^∗∗∗)) and could thus be conveniently PoC detected in 5 min by ImplantSafe. Any forms or total MMP-9 did –not differentiate peri-implantitis and healthy sites (a).