Combining oral fluid aMMP-8, calprotectin, and CCAAs in dental panoramic radiography for periodontal disease and systemic disease risk assessment: a point-of-care diagnostic approach.

Introduction: Calcifying carotid artery atheromas (CCAAs) identified on standard dental panoramic radiographs (DPRs) have been presented as potential disease markers for cardiovascular disease (CVD). CCAAs are further linked to several systemic disease processes (i.e. diabetes) that are also associated with periodontitis. The active matrix metalloproteinase-8 (aMMP-8) mouthrinse point-of-care-test has been extensively validated for periodontitis disease diagnostics. Calprotectin can inhibit matrix metalloproteinases and also exert significant anti-microbial activities. Recently, calprotectin has been suggested as a potential biomarker of endovascular inflammation.

Areas covered: This special report considers a combination of mouthrinse aMMP-8 and calprotectin in periodontitis disease diagnostics at the dentist's office for simultaneously identifying patients at risk of diabetes and CVD reviewing recent PubMed indexed findings comparing disease diagnostics by aMMP-8 and calprotectin individually and combined.

Expert opinion: Combining CCAA-DPRs analysis with oral fluid mouthrinse aMMP-8 and calprotectin lateral-flow immunoassays as point-of-care or chair-side tests, especially by polynomial algorithm-based machine learning technologies (including computer vision), can provide a modern, noninvasive, safe, and economical AI-based diagnostic tool. This tool can be utilized for online real-time screening of interlinked processes involving stroke, CVD, diabetes, and periodontal disease cascades. Accordingly, identified at-risk patients are then referred for necessary medical and dental interventions.