Diagnostic Accuracy of Matrix Metalloproteinase-8 for Detecting Periodontal Disease: A Meta-Analysis

Matrix metalloproteinase-8 (MMP-8) serves as a biomarker for periodontal diseases; numerous studies have demonstrated its diagnostic accuracy in detecting both periodontitis and gingivitis.

A comprehensive search was performed up to 25 March 2025. Observational studies investigating MMP-8's diagnostic potential for periodontal disease and gingivitis were included. Pooled sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated using Stata 15.1, with diagnostic accuracy measures reported as point estimates and 95% confidence intervals (CI).

The meta-analysis included 22 diagnostic studies encompassing 2492 participants. Pooled estimates demonstrated robust diagnostic performance of MMP-8 for periodontal disease, with sensitivity of 0.83 (95% CI: 0.78-0.87), specificity of 0.77 (95% CI: 0.71-0.83), and AUC of 0.87 (95% CI: 0.84-0.90). Subgroup analysis revealed superior accuracy of immunofluorometric assay (IFMA), showing higher sensitivity (0.88) and specificity (0.77) compared to enzyme-linked immunosorbent assay (ELISA, sensitivity/specificity = 0.84/0.76) and point-of-care testing (POCT, sensitivity/specificity = 0.73/0.64). Biological sample comparisons identified gingival crevicular fluid as the optimal source, achieving significantly higher diagnostic accuracy (AUC = 0.91) than mouth rinse (AUC = 0.89) or saliva (AUC = 0.76).

Our findings demonstrated that MMP-8 serves as a robust diagnostic biomarker for both periodontitis and gingivitis, with detection methods-IFMA, ELISA, and POCT-showing context-dependent applicability across clinical settings.