Diagnostic value of aMMP-8 and Azurocidin in Peri-implant Sulcular Fluid as biomarkers of peri-implant health or disease
Creators: name: Ξανθοπούλου, Βηθλεέμ Γρηγορίου
Publisher: name: Aristotle University of Thessaloniki
Year: 2023
Subjects: aMMP-8
Αζουροσιδίνη
Περιεμφυτευματική υγεία
Περιεμφυτευματίτιδα
Azurocidin
Peri-implant health
Peri-implant disease

description: The aim of the present study was to investigate the potential of testing for aMMP-8 by a quantitative Point-of-Care (PoC), chairside lateral-flow immunotest and azurocidin as biomarkers for the presence or absence of peri-implant diseases. The study was designed as a cross-sectional study. Eighty consecutive patients were recruited from the Department of Periodontology and Implant Biology of the Dental Faculty, School of Health Sciences, Aristotle University of Thessaloniki, Greece, from September 2021 to September 2022. Before clinical examination and diagnosis, the first sample was taken from the Peri- Implant Sulcular Fluid (PISF) for analysis of aMMP-8 levels preferably from either the mesio-buccal or the disto-buccal site of the implant and the second for azurocidin analysis. The collected PISF was analyzed for quantitative assessment of aMMP8 levels using the Implantsafe® test (Dentognostics GmbH) and the accompanying digital reader (ORALyzer®), according with the manufacturer’s instructions and levels were expressed in ng / ml. The second sample was analyzed with ELISA technique. Following collection and analysis of PISF, clinical examination was performed. Radiographic imaging of the implants followed the clinical examination. The type of implants and their prosthetic restoration were also evaluated. Following clinical and radiographic examination, a diagnosis was made regarding the periodontal status of the whole dentition and the implant under investigation, according to the 2018 classification of periodontal and peri-implant diseases. Concerning statistical analysis, comparisons of aMMP-8 / azurocidin levels and clinical parameters were analyzed by Kruskal-Wallis test and pairwise post hoc Dunn-Bonferroni test. A Receiver Operator Curve (ROC) analysis was used to analyze the diagnostic ability of aMMP-8 (ng/ml) and Area Under the Curve (AUC) was calculated and the correlation between aMMP-8 / azurocidin levels and probing depth of the sampled site was sought by the Spearman’s rho and the coefficient of determination (R2). Patients with healthy implants, peri-implant mucositis or peri-implantitis did not differ regarding age or sex distribution (age range 52.5+12.9 years ,57.6+10 and 62.6 + 7 years respectively). Regarding Probing Depth of the investigated implant, statistically significant differences were observed, between healthy implants and peri-implantitis (3.11 ± 0.43 and 5.87±1.90 mm respectively) and between implants with peri-implant mucositis and those with peri-implantis (3.21±0.31 and 5.87±1.90 mm respectively). The same pattern of statistically significant differences was observed for Clinical Attachment Level assessments with no differences observed between healthy implants and peri-implant mucositis (3.29±0.60 and 3.28±0.32 mm respectively), but statistically significant differences observed between healthy implants and peri-implantitis (3.29±0.60 and 6.19±1.98 mm respectively) as well as between peri-implant mucositis and peri-implantitis (3.28±0.32 and 6.19±1.98 mm respectively). Regarding Bleeding on Probing, only healthy implants displayed statistically significant differences vs implants with peri-implant mucositis or peri-implantitis (no bleeding vs 0.65±0.20% and 0.88±1.64% respectively. A Receiver Operator Curve (ROC) analysis was also performed to analyze the diagnostic ability of aMMP-8 (ng/ml) to discriminate patients with at least one site with ≥5mm PD together with BOP on the implant. Area under the curve (AUC) was also calculated (AUC=0.798; 95% confidence interval 0.665–0.932; p &lt; 0.001), and optimal cutoff a-MMP8 value was estimated by Youden's index (aMMP-8: 32.15 ng/ml; sensitivity: 0.867; specificity: 0.677). The correlation between Probing Depth of the sampled site of all implants, was calculated by both the Spearman’s rho and the coefficient of determination (R2) by the fitted linear regression model. Both analyses displayed a statistically significant positive correlation between increasing probing depths and aMMP-8 levels (rho=0.509, R2=0.398; p&lt;0.001). Concerning the azurocidin levels in the PISF our study did not find any statistically significant differences between the peri-implant healthy, peri-implant mucositis and peri-implantitis groups. Furthermore, the diagnostic accuracy of azurocidin was inferior compared to active MMP-8 in discriminating peri-implant conditions (AUC: 0.860/0.463, respectively). Taken collectively, it is suggested from the present findings that the aMMP-8 -enzyme chairside lateral flow immunotest can be a beneficial adjunctive diagnostic tool for early identification and screening of the risk of peri-implant diseases.
description: Σκοπός της μελέτης ήταν η διερέυνηση της διαγνωστικής αξίας της MMP-8 και της αζουροσιδίνης στο υγρό της περιεμφυτευματικής σχισμής ως βιοδεικτών της περιεμφυτευματικής υγείας ή φλεγμονής. Επιλέχθηκαν ογδόντα υγιείς ασθενείς με εμφυτεύματα, τα οποία ήταν λειτουργικά φορτισμένα για τουλάχιστον ένα έτος. Τα δείγματα συλλέχθηκαν από το υγρό της περιεμφυτευματικής σχισμής και αναλύθηκαν ποσοτικά για τα επίπεδα της aMMP-8 σε ng/ml με τη συσκευή που συνοδεύει το τέστ (OraLyzer®) και για την αζουροσιδίνη με τη τεχνική της ELISA. Καταγράφηκαν κλινικοί δείκτες, οι οποίοι περιλάμβαναν βάθος ανίχνευσης θυλάκου, κλινική απώλεια πρόσφυσης, αιμορραγία κατά την ανίχνευση και δείκτη πλάκας και πραγματοποιήθηκε ακτινογραφική αξιολόγηση. Από τη στατιστική ανάλυση προέκυψαν στατιστικά σημαντικές διαφορές στα επίπεδα της aMMP-8 μεταξύ των υγιών ασθενών και αυτών με περιβλεννογονίτιδα και περιεμφυτευματίτιδα (13.65±7.18 και 32.33±21.20, αντίστοιχα) και μεταξύ των ασθενών με περιβλεννογονίτιδα και περιεμφυτευματίτιδα (32.33±21.20 και 73.07±43.93, αντίστοιχα). Τα αυξημένα βάθη θυλάκου στη περιοχή δειγματοληψίας και τα επίπεδα της aMMP-8 συσχετίστηκαν σημαντικά. Όσον αφορά τα επίπεδα αζουροσιδίνης στο υγρό της περιεμφυτευματικής σχισμής, η μελέτη μας δεν βρήκε στατιστικά σημαντικές διαφορές μεταξύ των ομάδων με υγιείς ασθενείς, με περιβλεννογονίτιδα και με περιεμφυτευματίτιδα. Τα δεδομένα υποδηλώνουν πως το aMMP-8 POC test μπορεί να είναι ένα συμπληρωματικό εργαλείο για την έγκαιρη αναγνώριση και τον έλεγχο του κινδύνου της περιεμφυτευματικής νόσου καθώς και για την εξέλιξη της.