MMP-8, IL-6 AND IL-1 Β: THE MOST PROMISING SALIVARY BIOMARKERS FOR EARLY DIAGNOSIS OF PERIODONTITIS

Abstract

Periodontal disease is a chronic inflammatory condition affecting the supporting structures of teeth, which if left untreated, worsens gradually and can have serious consequences on the periodontium. There are several risk factors for periodontitis but smoking or tobacco use, and poor oral hygiene are the leading cause. Early diagnosis of periodontal disease is essential for successful treatment outcomes. Traditional diagnostic methods rely on clinical assessment and radiographic imaging, but these methods have limitations, particularly in identifying early-stage disease. According to W.H.O, it was reported that 18% population of Pakistan has some form of periodontal problems and out of these 31% has periodontitis. The purpose of this study is to evaluate salivary levels of MMP-8, IL-1β and IL-6 in healthy and periodontitis patients and to assess the association between these biomarkers’ levels and clinical parameters. This was a case control study which was conducted at the Dental OPD of Bahria University Medical Health Sciences Karachi over a period of six months. 76 participants were included in the study after randomization, 38 subjects for control group and 38 subjects for case group. In control group a healthy periodontium is defined as the absence of either gingivitis or periodontitis history (BOP < 10%, PPD ≤ 3 mm, no proximal clinical attachment loss (CAL), and no recession).In case group periodontitis patient defined as a patient who had at least two nonadjacent teeth with interdental clinical attachment loss (CAL) ≥ 2 mm, probing pocket depth (PPD) > 3 mm, and radiographic evidence of bone loss. Periodontal examination and saliva sampling were performed in all patients. Saliva sample was taken for measuring different parameters like Plaque Index (PI), Calculus Index (CI), Periodontal Probing Depth (PPD), Clinical Attachment Loss (CAL) and Bleeding on Probing (BOP), after taking ethical approval from Bahria University Health Sciences Karachi (BUHSCK). Levels of salivary cytokines including MMP-8, IL-1β and IL-6 were evaluated by sandwich ELISA test kit. For Statistical analysis: Data analysis was done by using IBM SPSS Statistics v27.Mean and standard deviation were calculated for quantitative variables whereas frequency and percentage were reported for qualitative VIII variables. Mean comparison of IL-1β, IL-6 and MMP-8 according to study groups were done by using independent t test. P- value less than 0.05 were considered as significant. Results: IL-1β, MMP-8 and IL-6 levels were significantly higher in periodontitis patients. We found significant association for gender(p=0.022), age groups(p=0.000), any co morbid (p=0.012), plaque (p=0.001), calculus(p=0.002), bleeding on probing (p=0.001) and clinical attachment loss (p=0.001) whereas no significant association were found with dietary habits, and medication use (p=0.108). Concentration of these proteins in saliva showed significant association with plaque index, calculus index, periodontal pocket depth and clinical attachment loss and it reflect the clinical status of diseased periodontium. In conclusion, salivary biomarkers have emerged as a promising tool for the early diagnosis and monitoring of periodontal disease by providing valuable information about disease status.