Association between aMMP-8 Chairside Test for Chronic Periodontitis and Selected Reproductive Health Parameters

There are many established measures of chronic periodontitis but with many limitations. The problem with these established measures is that they assess past disease rather the present physiology of periodontal tissues. To overcome these limitations, scientists conceived the idea of a novel system to assess chronic periodontitis accurately and predictably. A novel system is sought that will favorably compare with established measures, while overcoming their limitations, and also providing high validity, sensitivity, specificity, reliability, and reproducibility. To investigate how a potential candidate for this system works, a series of studies were conducted in Nigeria and Helsinki. The goal was to assess how well a novel point-of-care test (aMMP-8 chairside test) measures up to these desirable objectives. The series of studies were conducted to investigate the validity in terms of sensitivity and specificity for chronic periodontitis. To achieve our objectives, in study (I), we assessed chronic periodontitis using a novel aMMP-8 test -neutrophil collagenase-2 lateral flow immunoassay. This test qualitatively detects the presence of matrix metalloproteinase-8. Its correlation with established measures of CP, like bleeding on probing (BOP) and probing pocket depth (PPD), was then assessed. The neutrophil collagenase-2 immunoassay was 96% sensitive for poor oral hygiene, 95% sensitive for chronic periodontitis, and 83% sensitive for BOP. In all instances, chronic periodontitis was regarded as two sites with PPD or BOP. The reproducibility of the novel aMMP-8 chairside test was investigated in study (II), where oral health and periodontal assessment was performed on adolescents at the Kotka Health Center in Finland. The sensitivity of the aMMP-8 test for 2 sites with PPD ≥ 4 mm was 63.6% and specificity 100%. Thus, the test is effective in recognizing oral inflammatory burden in adults and adolescents with early signs of periodontitis. Bacterial biofilm has been established as the primary etiological agent for chronic periodontitis. Similarly, the oral manifestations of systemic diseases and conditions that predispose to chronic periodontitis are well-reported in the literature. The impact of chronic periodontitis on systemic health, however, has been under-reported until a few decades ago. Thus, the validity, sensitivity, specificity, reliability and reproducibility of the aMMP-8 chairside test was first established. After this, its applicability was assessed in the primary health care setting, as it applies to dentistry as well as general health. The role of chronic periodontitis (CP) on fertility-related events was of a particular interest in this investigation. In study III, the levels of MMP-8 were assessed in pregnant women and a widespread (87.3%) elevation of active matrixmetalloproteinase-8 was evident among the black pregnant Nigerians. Independent of demographics, educational level, and trimester, positive test results were more abundant among the study subjects than what could be anticipated from previous studies performed on proteolytic enzymes in saliva. Finally, the link between chronic periodontitis and time to conception (TTC) was investigated in study IV using the aMMP-8 test. Through a cross-sectional hospital survey involving 58 fertility clinic attendees and 70 pregnant controls, the odds of increased conception were higher with the aMMP-8-test-assessed periodontitis risk (OR 0.157, 95% CI 0.041-0.600, P < 0.01).aMMP-8 suuhuuhde-tuolinvierustestin validointi aikuisten ja nuorten alkavaan parodontiittiin/preparodontiittiin Neutrofiili kollagenaasi, kollagenaasi-2, matriksi metalloproteinaasi (MMP)-8 on ien- ja hammasistuke- (hammasimplantti) sairauksien pääasiallinen kollagenolyyttinen, proteolyyttinen kudostuhon aiheuttaja tulehtuneessa ikenessä ja alveoliluussa. Dysbioottinen parodontopatogeeninen plakki eli bakteerit ja niiden virulenssitekijät ja proteaasit kykenevät indusoimaan MMP-8:n synteesin ja degranulaation ja lisäksi aktivoimaan latentin proMMP-8:n aktiiviseksi, katalyyttisesti kompetentiksi aMMP-8:ksi. aMMP-8:n pitoisuus suunesteessä (sylki, suuhuuhde, ientaskuneste, hammasimplanttineste) kohoaa, heijastaen edeltäen ja ennustaen, kliinistä ja eritoten aktiivista ien- ja hammasistukesairautta. Raskaustesti-tyyppinen suuneste-aMMP-8 –testi on toimiva ja käyttökelpoinen parodontiitin ja peri-implantiitin biomarkkeri. Helsingin yliopiston ja Tukholman Karolinska Instututetin parodontologian professorin ja ylihammaslääkärin Timo Sorsan keksimä, patentoima ja kehittämä aMMP-8 suuhuuhde tuolinvierustesti (PerioSafe®) validoitiin HLL Solomon Nwhatorin väitöskirjatyössä aikuisparodontiitille Nigeriassa ja nuorten alkavalle parodontiitille/preparodontiitille Suomessa. Testin sensitiivisyys parodontiitille on 95% ja spesifisyys 80 – 90%; testi siis tunnisti iensairaat aikuiset ja nuoret, eikä tehnyt terveistä sairaita. Testi havaittiin tarkemmaksi ja käyttö kelpoisemmaksi kuin perinteinen parodontologinen ”bleeding-on-probing/verenvuotoa koetettaessa” –määritys. Afrikkalaisilla naisilla aMMP-8 –testipositiivisuutta eli parodontiittia esiintyi laajalti raskaina olevilla naisilla ja testipositiivisuus/parodontiitti viivästytti merkitsevästi raskaaksi tulemista. Nuorten alkavan parodonttiin/preparodontiitin testi löysi tehokkaasti ja tarkasti. Väitöskirjatyön tulokset osoittivat, että aMMP-8 suuhuuhde tuolin-vierustesti on kätevä diagnostinen väline parodontiitin diagnostiikkaan, ja ao. testiä voivat käyttää ja myös lääkärit, suuhygienistit, sairaanhoitajat ja kätilöt. Testi on ei-invasiivinen eikä siis aiheuta koskaan bakteremiaa poiketen täten edukseen invasiivisesta ja aina bakteremiaa aiheuttavasta ”bleeding-on-probing/verenvuotoa koeteltaessa” -testauksesta. Sittemmin kvalitatiivisesta raskaustesti-tyyppisestä testistä (PerioSafe®) on kehitetty kaupallisesti saatava kvantitatiivinen testi (PerioSafe®/OralLyser®)

Self-assessed dental health knowledge of Nigerian Doctors

Objectives: To assess medical doctors' knowledge of common dental diseases and the need to include dental education in the Nigerian undergraduate medical curriculum.Design: Cross-sectional multicentre non-random survey using a convenience sample.Setting: Tertiary hospitals across two geo-political zones of Nigeria. Participants were mostly recruited while attending seminars and other departmental events which brought doctors together.Subjects: Medical doctors in tertiary hospitals across two geo-political zones of Nigeria.Main outcome measures: Knowledge of common dental diseases namely, dental caries, gingivitis and periodontitis was evaluated using an open-ended questionnaire. The definition, etiology, treatment and age-related risk were  assessed. Exposure to dental education during undergraduate training was assessed. Opinion on desirability and suggested length of future training were also assessed.Results: A total of 127 doctors (35 interns, 30 residents, 34 senior residents and 28 consultants) participated in the study. Overall, knowledge of definition, etiology, treatment and relative prevalence were recorded. About 69 doctors (54.3%) correctly defined dental caries, 120 (94.5%) correctly defined gingivitis while only only 29 (22.8%) correctly defined chronic periodontitis. The proportions of respondents who correctly identified disease etiology were 26  (20.5%) for caries, 31 (24.4%) for gingivitis and 12 (9.4%) for chronic periodontitis. The proportions of respondents who correctly identified appropriate treatment modalities were 39 (30.7%) for caries, 18 (14.2%) for gingivitis and 6 (4.7%) for periodontitis. Those who correctly identified the relative, age-related prevalence of the three diseases were 81 (63.8%) for caries, 51 (40.2%) for gingivitis and 47 (37%) for periodontitis.Conclusion: Most of the medical doctors who participated in the study demonstrated inadequate knowledge of  common dental diseases and about 97% of respondents supported the idea of including dental education into the current Nigerian undergraduate medical curriculum

Influences on smoking behaviour of adolescents and young adults in a Nigerian university

The study investigated whether parenting style, parental level of education and smoking peers have any influence on the smoking behaviour of adolescents and young adults. The participants were students of Obafemi Awolowo University, Ile-Ife, Nigeria. Purposive sampling technique was adopted in the sample selection. Three hundred students who consented participated in the study. A self constructed questionnaire was used to collect the data. The validity of the instrument was determined. The reliability of the instrument was also determined using test retest method. Correlation co-efficient of 0.75 was obtained. This study revealed that there is a significant influence of parenting style on the smoking behaviour of students (x2 = 36.03, df = 6, p ≤ 0.05). It also showed that there is a significant relationship between parents’ educational attainment and students’ smoking behaviour (x2 = 60.40, df = 6, p ≤ 0.05). Finally, it was revealed that there was a significant influence of peers on smoking behaviour (x2 = 19.97, df = 2, p ≤ 0.05). KEY WORDS: Smoking, Behaviour, Parent, Adolescent, Universit

Born too young and likely to die : Should this continue?

Peer reviewe

Active matrix metalloproteinase-8 : A potential biomarker of oral systemic link

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.Peer reviewe

Determinants of journal choice among Nigerian medics

Abstract Introduction: Despite the well-known maxim &quot;publish or perish&quot; among academicians, productivity remains low in Nigeria. There are barriers t

Could Periodontitis Affect Time to Conception?

Background: Chronic periodontitis is gaining increasing prominence as a potential influnce on systemic health. Time to conception has been recently investigated in relation to chronic periodontitis among Caucasians. The authors set out to replicate the study among Nigerian pregnant women. Aim: The etiology of many medical conditions have been linked with the state of the oral health and one of such is the time to conception (TTC)among women. This study was aimed to assess the effect of periodontitis on TTC.Subjects and Methods: A cross.sectional study in a hospital setting involving 58 fertility clinic attendees and 70 pregnant controls using the simplified oral hygiene index, community periodontal index (CPI) and matrix metalloproteinase.8 immunoassay. Statistical analysis used included Spearmanfs rank order correlation statistic, Z.statistic and logistic regression.Results: Good oral hygiene correlated with shorter TTC (&lt;1 year) than fair oral hygiene, but not statistically significant. The odds of increased conception were higher with CPI (odds ratio [OR]: 0.482, 95% confidence interval [CI]: 0.259.0.895, P = 0.02), periodontitis risk (OR 0.157, 95% CI 0.041.0.600, P &lt; 0.01) and age (OR 0.842, 95% CI 0.756.0.938, P &lt; 0.01). Conclusion: Chronic periodontitis was positively associated with increased TTC in the present study. The authors are recommending that women in child bearing age should be encouraged to have regular preventive dental check.ups in order to maintain good oral and periodontal health.Keywords: Fertility, Oral hygiene, Periodontitis, Time to conceptio

Active MMP-8 (aMMP-8) as a Grading and Staging Biomarker in the Periodontitis Classification

The aim of this study was to investigate the utility of incorporating active matrix metalloproteinase-8 (aMMP-8) as a biomarker into the new periodontitis classification system (stage/grade) presented in 2018. This study included 150 Greek adults aged 25–78, of whom 74 were men and 76 women. Participants were tested with an aMMP-8 point-of-care mouthrinse test, after which a full-mouth clinical examination was performed to assess their periodontal and oral health. The aMMP-8 levels in mouthrinse were significantly lower among healthy patients compared with patients in more severe periodontitis stages and grades (Kruskal–Wallis test and Dunn–Bonferroni test for pairwise post-hoc comparisons; p < 0.01 and p < 0.05, respectively). Furthermore, aMMP-8 levels were less correlated with plaque levels than bleeding on probing (BOP) (Spearman’s rho = 0.269, p < 0.001; Spearman’s rho = 0.586, p < 0.001); respectively). Thus, aMMP-8 was more robust to the confounding effects of oral hygiene than traditional periodontal parameter bleeding on probing. The aMMP-8 point-of-care mouthrinse test can be utilized as an adjunctive and preventive diagnostic tool to identify periodontal disease, classified by stage and grade, and ongoing periodontal breakdown chairside in clinical practice in only 5 min. Overall, integrating aMMP-8 into the new periodontitis classification system seems beneficial

aMMP-8 Point-of-Care/Chairside Oral Fluid Technology as a Rapid, Non-Invasive Tool for Periodontitis and Peri-Implantitis Screening in a Medical Care Setting

This communication article addresses currently available rapid non-invasive methods to screen and detect periodontitis and dental peri-implantitis. In this regard, oral fluid biomarkers have been researched extensively but self-reported oral health (SROH)-questionnaires have also been developed. Both alternatives may offer a quick and easy way to screen and detect diseased patients. Active matrix metalloproteinase (aMMP-8) is one of the most validated biomarkers for screening and detecting periodontal breakdown related to periodontitis and peri-implantitis and monitoring their treatment effects revealing successful, less- and non-successful treatment results. Currently available aMMP-8 lateral-flow technologies allow this kind of analysis, as demonstrated here, to be conducted quantitatively online and real-time as point-of-care/chairside testing in dental and even medical care settings. In this study, an aMMP-8 peri-implant sulcular fluid point-of-care-test diagnosed peri-implantitis and healthy implants far more accurately than bleeding-on-probing or the other biomarkers, such as polymorphonuclear (PMN)/neutrophil elastase, myeloperoxidase and MMP-9. Although, SROH-questionnaires allow screening in similar settings but they lack the information about the current disease activity of periodontitis and peri-implantitis, which is of essential value in periodontal diagnostics and treatment monitoring. Thus, both methods can be considered as adjunct methods for periodontitis and peri-implant diagnostics, but the value of oral fluid biomarkers analysis does not seem to be substitutable.Peer reviewe

Ability of matrix metalloproteinase-8 biosensor, IFMA, and ELISA immunoassays to differentiate between periodontal health, gingivitis, and periodontitis

Publisher Copyright: © 2022 The Authors. Journal of Periodontal Research published by John Wiley & Sons Ltd.Objective: The aim of this study was to determine the diagnostic utility of an MMP-8 biosensor assay in differentiating periodontal health from gingivitis and periodontitis and compare it with an established time-resolved immunofluorescence assay (IFMA) and enzyme-linked immunosorbent assay (ELISA). Background: Currently available antibody-based assays display a wide variability in their ability to accurately measure matrix metalloproteinase-8 (MMP-8) levels in saliva. Methods: Salivary MMP-8 levels were analyzed in 189 systemically healthy participants using an antibody-based biosensor prototype that operates using a surface acoustic wave technology and compared with IFMA and ELISA antibody assays. Participants were categorized into 3 groups: periodontal health (59), gingivitis (63), and periodontitis (67). A sub-population of participants (n = 20) with periodontitis received periodontal treatment and were monitored for 6 months. Results: All the assays demonstrated significantly higher salivary MMP-8 concentrations in participants with periodontitis versus gingivitis, periodontitis versus health, and gingivitis versus health (all p <.05). The biosensor data demonstrated significant correlations with IFMA (r =.354, p <.001) and ELISA (r =.681, p <.001). Significant reductions in salivary MMP-8 concentrations were detected by the biosensor (p =.030) and IFMA (p =.002) in participants with periodontitis 6 months after non-surgical periodontal treatment. IFMA had the best sensitivity (89.2%) for detecting periodontitis and gingivitis versus health and 96.6% for detecting periodontitis versus health and gingivitis. The biosensor had an AUC value of 0.81 and diagnostic accuracy of 74.2% for differentiating periodontitis and gingivitis from health; an AUC value of 0.86 and diagnostic accuracy of 82.8% for periodontitis versus health and gingivitis. Conclusions: The biosensor, IFMA, and ELISA assays differentiated between periodontal health, gingivitis, and periodontitis based on salivary MMP-8 levels. Only the biosensor and, particularly, IFMA identified an effect of periodontal treatment in the participants with periodontitis. Our findings support the potential utility of salivary oral fluid aMMP-8-based point-of-care technology in the future of periodontal diagnostics.Peer reviewe