ABSTRACT
Background: chronic periodontitis is probably one of the most common bacterial infections in humans. Microorganisms within the gingival crevice and the periodontal pocket play a significant role in its initiation and progression. The traditional diagnosis of chronic periodontitis requires massive tissue destruction. Therefore, knowledge of disease progression prior to influential destruction will allow for treatment to achieve the best results. MMP-8 is a good biomarker that can be used for this purpose and also is its activator MMP-3
Aim of the work: assessment of MMP-8 and MMP-3 as biomarkers and indicators in the diagnosis of chronic adult periodontitis
Methods: immunologic screening of MMP-8 levels in GCF by ELISA. MMP-3 was immunohistochemically localized and its cellular origin in inflamed human gingival tissue was detected the study included thirty-two patients divided into two groups: A study group: included twenty four patients with chronic periodontitis and was subdivided into three subgroups: Subgroup [A]: Included eight patients treated only by scaling and root planning [SRP]. Subgroup [B]: Included eight patients treated with oral Doxycycline 20 mg twice a day in addition to [SRP]. Subgroup [C]: included eight patients surgically treated to remove the periodontal pockets in addition to [SRP]. A group including eight clinically normal individuals was used as a control group
Results: the results showed a statistically significant change in the level of MMP-8 in subgroups A, B, C after treatment compared to day 0 [p<0.000l] and to the control group. On clinical examination there was also a statistically significant improvement in patients of both subgroups [B] and [C] compared to group [A] after three months of treatment. The results of examining gum tissue samples from subgroup [C] patients showed the presence of positive MMP-3 immunoreaction in all cases in the basal and suprabasal layers as well as in lymphocytes and macrophages. Weak positive MMP-3 immunoreaction was detected in three out of the eight control samples [37.5%]
Conclusion: it was concluded that MMP- 8 levels in GCF in periodontitis patients decreased with different treatment modalities and this was associated with improvement in the clinical periodontal parameters. GCF MMP-8 concentrations differentiate periodontally healthy subjects from diseased ones. In addition to this comes MMP-3 that activates pro MMP-8. MMP-3 expression in chronic periodontitis was found to originate from residual gingival fibroblasts epithelial cells and macrophages. Improvement in biochemical and clinical outcomes was move pronounced in patients receiving a subantimicrobial dose of Doxycycline 20 mg twice a day
Abbreviations: MMPs, matrix mefalloproteinases; GCF, gingival crevicular fluid; PI, plaque index; GI, gingival index; PD, probe or periodontal pocket depths; AL, periodontal attachment level; SRP, scaling and root planning