Active Matrixmetalloproteinase-8 in Periodontal Diagnosis: A Scoping Review

Background/Objectives: Periodontitis is a chronic inflammatory disease initiated by dysbiotic biofilms and driven by host immune dysregulation, leading to connective tissue destruction and alveolar bone loss. Its early diagnosis is closely linked to the progression and outcome of the disease. Active-matrix metalloproteinase-8 (aMMP-8) is one of the key biomarkers for estimating irreversible collagenolytic degradation. aMMP-8 is among the key biomarkers for estimating irreversible collagenolytic degradation. To evaluate the role of oral fluid/salivary/mouthrinse aMMP-8 tests for early detection and treatment monitoring of periodontitis. Methods: A search was conducted in the Medline, Embase, Scopus, and Cochrane databases, restricted to articles published between January 2020 and December 2024 to capture the most recent literature. Pilot, cohort, case-control, and cross-sectional studies were included, while studies not aligning with the objectives of this review, as well as narrative reviews, editorials, and opinions were excluded. Results: A total of 276 articles were retrieved. After removing duplicates, 226 studies remained, of which 216 were retained following title, abstract, and keyword screening. From these, 26 studies were finally included in this review. aMMP-8 point-of-care tests appear to be promising tools for early diagnosis, disease severity assessment, and treatment monitoring in periodontitis, though findings remain conflicting across studies. Elevated aMMP-8 levels are associated with active periodontal pathology and tissue destruction, reflecting ongoing collagenolytic degeneration. Conclusions: aMMP-8 mouthrinse, saliva, or oral fluid tests can be used for predictive and early diagnosis as well as for treatment monitoring in patients with periodontal disease, and they function effectively as biomarkers for periodontitis.