The Utility of Gingival Crevicular Fluid Matrix Metalloproteinase-8 Response Patterns in Prediction of Site-Level Clinical Treatment Outcome

WOS: 000355265900006PubMed ID: 25741578Background: Different gingival crevicular fluid (GCF) matrix metalloproteinase (MMP)-8 response patterns were studied among non-smoking and smoking patients with chronic periodontitis (CP) and generalized aggressive periodontitis (GAgP) to test the utility of GCF MMP-8 levels predicting the site-level treatment outcome. Methods: Data from four independent longitudinal studies were combined. Altogether, the studies included 158 periodontal sites from 67 patients with CP and 32 patients with GAgP, and GCF samples were collected at baseline, after the treatment, and during the 6-month maintenance period. All GCF samples were analyzed by immunofluorometric assay for MMP-8. Different site-level MMP-8 response patterns were explored by the cluster analysis. Most optimal MMP-8 cutoff levels were searched with receiver operating characteristic analyses, and the predictive utility of defined levels was tested. Results: Distinct types of MMP-8 response patterns were found in both smokers and non-smokers. MMP-8 levels exceeding the optimal cutoff levels separately defined for smokers and non-smokers indicated increased risk for compromised treatment outcome at baseline and during the maintenance period. Seventy-one percent of non-smokers (positive likelihood ratio of 4.22) and 88% of smokers (positive likelihood ratio of 5.00) with positive test results at both baseline and the maintenance period had compromised treatment outcome. The double-positive result indicated 46% and 39% point risk increase for the compromised outcome, respectively. Conclusion: GCF MMP-8 analysis with defined cutoff levels could be used to predict the site-level treatment outcome and for longitudinal monitoring of the disease status during the maintenance period.Academy of Finland, Helsinki University Central HospitalAcademy of Finland [TYH 2013353, TYH 2014244]; Finnish Dental Society Apollonia; Finnish Doctoral Program in Oral SciencesThis work was supported by the Academy of Finland, Helsinki University Central Hospital Grants TYH 2013353 and TYH 2014244, and grants from the Finnish Dental Society Apollonia and the Finnish Doctoral Program in Oral Sciences. Dr. Sorsa is an inventor of the oral fluid diagnostic U.S. Patents 5652227, 5736341, 5866432, and 6143476. Drs. Leppilahti, Kallio, Tervahartiala, Emingil, Han, and Mantyla report no conflicts of interest related to this study