# Diagnostic value of aMMP‐8 and azurocidin in peri‐implant sulcular fluid as biomarkers of peri‐implant health or disease

## TL;DR

This study shows that aMMP-8 testing in fluid around dental implants can help detect implant diseases with reasonable accuracy.

## Contribution

The study introduces aMMP-8 as a novel, quantitative point-of-care biomarker for diagnosing peri-implant diseases.

## Key findings

- aMMP-8 levels significantly differ between healthy implants, mucositis, and peri-implantitis.
- aMMP-8 test with 20 ng/mL threshold has 71.7% sensitivity and 77.8% specificity for peri-implantitis detection.
- The aMMP-8 test achieves 77.5% accuracy at a 33.7 ng/mL cutoff, outperforming bleeding on probing.

## Abstract

The objective of this study was to investigate the effectiveness of testing for active matrix metalloproteinase‐8 (aMMP‐8) by a quantitative point‐of‐care (PoC), chairside lateral flow immunotest and azurocidin, in the peri‐implant sulcular fluid (PISF), as biomarkers for the presence or absence of peri‐implant diseases.

Current research indicates that proinflammatory cytokines and extracellular matrix‐degrading enzymes may be of value to diagnose and predict peri‐implant disease initiation and progression, but more data are needed.

Eighty patients with implants were recruited. PISF samples were collected and quantitatively analyzed for aMMP‐8 (chairside) and azurocidin with ELISA. Radiographic assessments and clinical indices (probing depth, probing attachment level, bleeding on probing, and plaque) were recorded after sampling. Kruskal‐Wallis test and pairwise post hoc Dunn‐Bonferroni test were used to relate aMMP‐8 levels and azurocidin levels to clinical parameters. The diagnostic ability of aMMP‐8 (ng/mL) and azurocidin was analyzed by receiver operator curve analysis. Area under the curve (AUC) was calculated and the Spearman's rho, and the coefficient of determination (R2) were used to calculate the correlations between aMMP‐8, azurocidin, and periodontal parameters.

Statistically significant differences were observed for aMMP‐8 levels but not for azurocidin between healthy implants, implants with mucositis, and those with peri‐implantitis (13.65 ± 7.18, 32.33 ± 21.20, and 73.07 ± 43.93 ng/mL, respectively), (Kruskall–Wallis test p < .05). The aMMP‐8 test with a threshold of 20 ng/mL has a sensitivity of 71.7% and a specificity of 77.8% to identify peri‐implantitis and healthy implants, respectively. AUC was found to be 0.814, and the accuracy of the method reaches 73.8%. Above a cutoff value of 33.7 ng/mL of aMMP‐8, the accuracy of the test to detect peri‐implantitis reaches 77.5% in relation to 62.5% of BoP from the same site.

Taken collectively, present data indicate that the aMMP‐8 PoC lateral flow immunotest can be a beneficial, adjunctive diagnostic quantitative tool for real‐time screening for peri‐implant diseases.