{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:38:42Z","timestamp":1784068722379,"version":"3.55.0"},"reference-count":83,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Helsinki and Uusimaa Hospital District (HUS), Finland","award":["TYH 2020337"],"award-info":[{"award-number":["TYH 2020337"]}]},{"name":"Helsinki and Uusimaa Hospital District (HUS), Finland","award":["TYH 2022225"],"award-info":[{"award-number":["TYH 2022225"]}]},{"name":"Helsinki and Uusimaa Hospital District (HUS), Finland","award":["Y2519SU010 (TS)"],"award-info":[{"award-number":["Y2519SU010 (TS)"]}]},{"name":"Finnish Dental Association Apol-lonia, Finland (TS)","award":["TYH 2020337"],"award-info":[{"award-number":["TYH 2020337"]}]},{"name":"Finnish Dental Association Apol-lonia, Finland (TS)","award":["TYH 2022225"],"award-info":[{"award-number":["TYH 2022225"]}]},{"name":"Finnish Dental Association Apol-lonia, Finland (TS)","award":["Y2519SU010 (TS)"],"award-info":[{"award-number":["Y2519SU010 (TS)"]}]},{"name":"Karolinska Institutet, Sweden (TS)","award":["TYH 2020337"],"award-info":[{"award-number":["TYH 2020337"]}]},{"name":"Karolinska Institutet, Sweden (TS)","award":["TYH 2022225"],"award-info":[{"award-number":["TYH 2022225"]}]},{"name":"Karolinska Institutet, Sweden (TS)","award":["Y2519SU010 (TS)"],"award-info":[{"award-number":["Y2519SU010 (TS)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: This narrative review paper highlights the multifaceted influence of dysbiotic biofilm, genetic background, host response, and environmental factors on periodontitis. It explores the roles of type I and II diabetes mellitus, gestational diabetes, and metabolic syndrome in the progression of periodontitis, drawing insights from various empirical studies and theoretical perspectives. Methods: Relevant articles were sourced using keywords in databases like PubMed\/Medline, Science Direct, Scopus, and Google Scholar. Additionally, this review examines the relationship between aMMP-8 levels and increased glycemic states, as well as varying degrees of periodontitis severity. Results: The biomarker active-matrix metalloproteinase-8 (aMMP-8), produced by polymorphonuclear leukocytes (PMN), is highlighted as a reliable indicator of ongoing connective tissue degradation. Dysfunctions in PMN activity, accumulation of advanced glycation end products (AGE), and oxidative stress aggravate the periodontal inflammatory response and complications of diabetes. Traditional diagnostics of periodontitis do not provide sufficient information about the current or future disease initiation or activity of periodontitis. Conclusions: The implications of this review point to the need for monitoring periodontal health by utilizing innovative strategies like aMMP-8 point-of-care testing, using oral rinse for screening and treatment monitoring, and harnessing the potential of supportive treatments like low-dose doxycycline and light-activated mouth rinses for restoring periodontal health. Its expression in oral fluids is a promising diagnostic tool to differentiate periodontitis from gingivitis and healthy periodontium, especially when associated with systemic diseases, fostering greater collaboration among healthcare professionals.<\/jats:p>","DOI":"10.3390\/diagnostics14242878","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T05:58:27Z","timestamp":1734933507000},"page":"2878","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Periodontitis, Metabolic Syndrome and Diabetes: Identifying Patients at Risk for Three Common Diseases Using the aMMP-8 Rapid Test at the Dentist\u2019s Office"],"prefix":"10.3390","volume":"14","author":[{"given":"Taija Kristiina","family":"Hopealaakso","sequence":"first","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\/0000-0003-2219-4689","authenticated-orcid":false,"given":"Tommi","family":"P\u00e4til\u00e4","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, New Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9532-8829","authenticated-orcid":false,"given":"Miika","family":"Penttala","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":"Dimitra","family":"Sakellari","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Health Sciences, Dental School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"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 Preventive Dentistry, Periodontology and Implant Biology, Faculty of Health Sciences, Dental School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"},{"name":"Dental Sector, 424 General Military Training Hospital, 564 29 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2097-2459","authenticated-orcid":false,"given":"Shipra","family":"Gupta","sequence":"additional","affiliation":[{"name":"Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh 160012, India"}],"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":"Department of Oral Diseases, Karolinska Institutet, 171 77 Stockholm, Sweden"}],"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"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/prd.12270","article-title":"Diabetes as a potential risk for periodontitis: Association studies","volume":"83","author":"Genco","year":"2020","journal-title":"Periodontology"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Gobin, R., Tian, D., Liu, Q., and Wang, J. 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