{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:11:56Z","timestamp":1788862316988,"version":"build-2803163510"},"reference-count":102,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Periodontitis is a chronic, biofilm-induced inflammatory disease characterized by episodic connective tissue destruction and is epidemiologically associated with cardiometabolic conditions, notably type 2 diabetes (T2D) and cardiovascular disease (CVD). Conventional clinical signs do not reliably distinguish quiescent from actively progressing disease, which delays intervention and interdisciplinary referral. Chair-side point-of-care testing (POCT) of oral fluids offers a pragmatic, non-invasive adjunct for real-time assessment of disease activity, not only in dental but also in medical settings. This narrative review, reported in line with the Scale for the Assessment of Narrative Review Articles (SANRA), examines the clinical rationale and current evidence for oral-rinse POCT targeting active matrix metalloproteinase-8 (aMMP-8) and calprotectin. Oral-rinse aMMP-8 reflects disease-active collagenolysis and shows the more robust single-marker performance for periodontitis, whereas oral-fluid calprotectin, a neutrophil-derived S100A8\/A9 protein, behaves as a predominantly local inflammatory signal and lacks validated oral-fluid reference ranges. Combining the two markers may add information beyond either alone when used in tandem as a complementary pair, but the supporting data are heterogeneous, largely exploratory, and hypothesis-generating. Dual-biomarker oral-rinse POCT is therefore best framed as a risk-stratification and referral aid rather than a stand-alone diagnostic, with combined interpretation potentially supported by AI technologies. Standardized pre-analytics, transparent threshold reporting, oral-fluid calprotectin reference values, and prospective multicenter validation are required before broad implementation.<\/jats:p>","DOI":"10.3390\/bioengineering13091042","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:02:24Z","timestamp":1788858144000},"page":"1042","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual-Biomarker Oral-Rinse Testing for aMMP-8 and Calprotectin: A Potential Adjunctive Tool for Risk Stratification and Interdisciplinary Referral in Periodontitis and Type 2 Diabetes"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1813-2468","authenticated-orcid":false,"given":"Pietro","family":"Leone","sequence":"first","affiliation":[{"name":"Smile Longevity Care 360 Centre, 80122 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5821-5299","authenticated-orcid":false,"given":"Ismo T.","family":"R\u00e4is\u00e4nen","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie Toby","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2994-8690","authenticated-orcid":false,"given":"Pirjo","family":"P\u00e4rn\u00e4nen","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6440-8780","authenticated-orcid":false,"given":"Sukumaran","family":"Anil","sequence":"additional","affiliation":[{"name":"Center of Excellence in Precision Medicine and Digital Health, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5542-2230","authenticated-orcid":false,"given":"Andreas","family":"Grigoriadis","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Dental Sector, 424 General Military Training Hospital, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Sakellari","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierino","family":"di Silverio","sequence":"additional","affiliation":[{"name":"Emerging Infectious Disease and High Contagiousness Unit, P.O. D. Cotugno-AORN Ospedali dei Colli, 80131 Naples, Italy"},{"name":"Regional Observatory for Infectious Disease, 80100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Evangelista","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera dei Colli, Monaldi Hospital, Cardiovascular and Dysmetabolic Internal Medicine Unit, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Sorsa","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, Head and Neck Center, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland"},{"name":"Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S162","DOI":"10.1111\/jcpe.12946","article-title":"Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"45","author":"Papapanou","year":"2018","journal-title":"J. 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