Given the association between periodontitis and various systemic diseases, early detection and treatment of this condition is paramount to overall well-being. Researchers have now developed an effective method to address this critical aspect.
Matrix metalloproteinase-8 is primarily an enzyme produced by human white blood cells or neutrophils and its role is to allow the passage of collagenolytic neutrophils into the area of inflammation by modifying the extracellular matrix. In patients with periodontitis, the aMMP-8 enzyme becomes catalytically active and tissue-destructive due to its abundant presence.6,7
According to Professor Timo Sorsa of the Department of Oral and Maxillofacial Diseases of the University of Helsinki, the use of the aMMP-8 test can measure and evaluate active and progressive attachment loss within five minutes, directly in the dentist’s chair and non-invasively. The test complements the diagnosis of periodontitis and peri-implantitis, monitors treatment results and supports maintenance therapy.6,7
A tool against systemic diseases
Professor Sorsa says aMMP-8 tests that measure periodontal and peri-implant disease activity accurately differentiate between diseased and healthy tissues. In patient care, the goal is a negative aMMP-8 test result. This indicates healthy tissue with a low risk of attachment loss and progression and can also be considered a biomarker of periodontal health.
The current oral health treatment protocol could be greatly improved by incorporating the developing aMMP-8 rapid test, which can easily identify not only periodontitis but also diabetes and its precursors based on oral enzyme substances. The aMMP-8 enzyme test can also speed up the diagnosis of gum disease in patients before dental implant surgery. While traditional methods involve growing problematic bacteria in laboratories, which takes days to weeks, the aMMP-8 test provides a faster alternative to identify problems before implant placement.8
Professor Sorsa says, “Results from the aMMP-8 enzyme test can be obtained within five minutes of performing the test. Research results are already promising about the functionality of the test, and a test of this kind could be in common use within the next five years.”
Effective and rapid diagnosis, screening and treatment of periodontitis can also positively influence diabetes treatment outcomes, potentially leading to reduced treatment costs. Diabetes control and successful treatment not only slows the progression of periodontitis but also helps reduce associated treatment costs.
Eliminate problem-causing bacteria
In addition to rapid diagnosis, there is an urgent need for more effective methods to eliminate problem-causing bacteria from the oral cavity. Research shows that 95% of all oral diseases are attributable to plaque. Harmful bacteria present in plaque can escalate the risk of serious conditions such as heart attacks and diabetes and even contribute to the development of serious types of cancer.9 Research shows that simply brushing your teeth is insufficient to eliminate these harmful bacteria.10
Ing-Marie Albinsson, dental hygienist at the Lilla Tandkronan Clinic in Arvika, Sweden, says: “Mechanical brushing is a very important step that removes around 65% of plaque, so we definitely need to continue to do it regularly. But to really get rid of all the harmful bacteria from the mouth, a supplement is needed.”
For this reason, Finnish researchers developed an antibacterial and light-activated device (Lumoral; not yet available in the United States) that targets dental plaque and eliminates harmful bacteria from the mouth. The method has been approved by the Finnish Oral Hygiene Association and is designed for home use. It works as a complementary tool to conventional oral hygiene practices such as brushing and flossing.10-12
Dr. Pätilä, founder of Koite Health (the Finnish company that developed this pioneering technology) and one of the key scientists behind the development of the device, says: “I have operated on many patients and in many cases I have noticed that the oral bacteria were responsible for causing heart problems. However, a pivotal moment occurred about a decade ago when I operated on a child suffering from a severe heart infection directly attributable to oral bacteria. At that point I realized that adequate action was needed to improve the oral health of both adults and children.” He stresses that the difficult thing about oral infections is that they often have no symptoms. If plaque is not properly removed, bacteria can pass through the gums into the bloodstream.
Preventing the spread of bacteria
How can you prevent bacteria from passing through the gums into the bloodstream? The first step is brushing and flossing (or using interdental brushes), but going a step further and adding a regular double light antibacterial treatment is an ideal supplement, especially for those with periodontal problems. Antibacterial photodynamic therapy prevents the formation of plaque and significantly reduces the number of periodontal bacteria in the mouth.12-14
Preliminary observations suggest that dual-light antibacterial therapy may even be an important tool in the armamentarium for the treatment of oral mucositis in patients undergoing cancer treatments, particularly radiation and chemotherapy. To date, no existing medication has effectively prevented the development of oral mucositis, but recent research suggests that double light antibacterial therapy may be an effective method of managing the symptoms of this condition.
A new PhD thesis will be started at the University of Helsinki in the spring to delve further into this topic.
Editor’s Note: This article first appeared on Clinical Insights newsletter, a publication of Endeavor Business Media Dental Group. Read more articles and Sign up.
bibliographical references
- Nazir M, Al-Ansari A, Al-Khalifa K, Alhareky M, Gaffar B, Almas K. Global prevalence of periodontal disease and its lack of surveillance. ScientificWorldJournal. 2020;2020:2146160. doi: 10.1155/2020/2146160
- Cecoro G, Annunziata M, Iuorio MT, Nastri L, Guida L. Periodontitis, low-grade inflammation and systemic health: a scoping review. Medicina (Kaunas). 2020;56(6):272. doi:10.3390/medicina56060272
- Petersen PE, Baehni PC. Periodontal health and global public health. Periodontol 2000. 2012? 60 (1): 7-14. doi:10.1111/j.1600-0757.2012.00452.x
- Bartold PM, Van Dyke TE. Periodontitis: a host-mediated disruption of microbial homeostasis. unlearning learning concepts. Periodontol 2000. 2013? 62 (1): 203-217. doi:10.1111/j.1600-0757.2012.00450.x
- Yu J, Ploner A, Chen MS, Zhang J, Sandborgh-Englund G, Ye W. Poor dental health and risk of pancreatic cancer: a national registry-based cohort study in Sweden, 2009–2016. Br J Cancer. 2022;127(12):2133-2140. doi:10.1038/s41416-022-02018-8
- Sorsa T, Alassiri S, Grigoriadis A, et al. Active MMP-8 (aMMP-8) as a grading and staging biomarker in periodontitis classification. Diagnostics (Basel). 2020? 10(2):61. doi:10.3390/diagnostics10020061
- Öztürk VÖ, Emingil G, Umeizudike K, et al. Evaluation of chairside active matrix metalloproteinase-8 (aMMP-8) assay as a diagnostic biomarker in periodontal disease staging. Arch Oral Biol. 2021;124:104955. doi:10.1016/j.archoralbio.2020.104955
- Lähteenmäki H, Räisänen IT, Pärnänen P, Tervahartiala T, Sorsa T. aMMP-8 enzyme test and dental implants. Suomen hammaslääkärielehti. 2021? 28 (11): 32-39.
- Gupta S, Räisänen IT, Seppänen H, et al. aMMP-8 POCT for periodontal disease: a marker of poor oral health. Cancer Control. 2023;30:10732748231214874. doi:10.1177/10732748231214874
- Aggarwal N, Gupta S, Grover R, Sadana G, Bansal K. Plaque removal efficacy of different toothbrushes: a comparative study. Int J Clin Pediatr Dent. 2019? 12 (5): 385-390. doi:10.5005/jp-journals-10005-1669
- The Finnish Oral Hygiene Association recommends Lumoral. Finnish Association of Dental Hygienists. September 1, 2022.
- Trujillo K, Räisänen IT, Sorsa T, Pätilä T. Repeated daily use of dual-light antibacterial photodynamic therapy in periodontal disease—a case report. Dent J (Basel). 2022? 10(9):163. doi:10.3390/dj10090163
- Pakarinen S, Saarela RKT, Välimaa H, et al. Home-applied double-light photodynamic therapy in the treatment of stable chronic periodontitis (HOPE-CP) — three-month interim results. Dent J (Basel). 2022? 10 (11): 206. doi:10.3390/dj10110206
- Gholami L, Shahabi S, Jazaeri M, Hadilou M, Fekrazad R. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol. 2023? 13:1020995. doi:10.3389/fmicb.2022.1020995
Nina Garlo-Melkas, MSc, is a health and science journalist working as a communications manager at Koite Health Ltd., a fast-growing health technology company and innovator of light-activated antibacterial solutions for the treatment and prevention of oral diseases.
