Cross‐sectional analysis of risk factors for subclinical periodontitis; active matrix metalloproteinase‐8 as a potential indicator in initial periodontitis in adolescents. Issue 5 (28th November 2018)

• Record Type: Journal Article
• Authors: Heikkinen, Anna Maria; Räisänen, Ismo T.; Tervahartiala, Taina; Sorsa, Timo
• Is Part Of: Journal of periodontology. Volume 90:Issue 5(2019)
• Page Start: 484
• Page End: 492
• Publication Date: 2018-11-28
• Subjects: adolescent -- leukocyte elastase -- matrix metalloproteinases -- periodontitis -- risk factors; Periodontics -- Periodicals; 617.632
• DOI: 10.1002/JPER.18-0450
• Languages: English
• ISSNs: 0022-3492

Abstract

Abstract: Background: The aim of this study was to investigate how different patient‐related risk indicators might be associated with the odds of developing subclinical periodontitis in adolescents. Methods: This cross‐sectional study included 252 Finnish individuals aged 15 to 16 years, of whom 141 were boys and 111 girls. A specially trained dentist performed clinical examinations: measurements included periodontal indexes (bleeding on probing, visible plaque index, root calculus, and probing depth, smoking by pack‐years, periodontal bacteria ( Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens, and Treponema denticola ) and the potential salivary periodontal biomarkers (active matrix metalloproteinase‐8 [aMMP‐8], polymorphonuclear leukocyte elastase [PMN elastase], and total protein, albumin, immunoglobulin A, immunoglobulin G, and immunoglobulin M). Results were analyzed by ordinal logistic regression, one‐way analysis of variance, Fisher exact test, and Kruskal‒Wallis H test. Results: The main finding of this study was that subclinical periodontitis in adolescents was statistically significantly associated with elevated salivary aMMP‐8 but not with PMN elastase. Also, adolescents with subclinical periodontitis had statistically significantly higher levels of bleeding on probing, root calculus, and dental plaque than adolescents without subclinical periodontitis. Conclusions: We suggest that the main risk factor for subclinical periodontitis in adolescents is the partly calcified, dysbiotic bacterial biofilm, which interacts with the immune defenses of the host; this leads to gingival inflammation and eventually to deepening periodontal pockets. This proinflammatory subclinical periodontitis stage, which represents stage I periodontitis in the new classification, is reflected as elevated salivary aMMP‐8 levels in oral fluids.