ASSOCIAÇÃO ENTRE NÍVEIS DE MMP-9 NO FLUIDO CREVICULAR GENGIVAL E OS PARÂMETROS CLÍNICOS PERIODONTAIS EM INDIVÍDUOS ADULTOS COM PERIODONTITE DURANTE TRATAMENTO NÃO CIRÚRGICO

Abstract

Introduction: Periodontitis is a multifactorial chronic inflammatory disease associated with dysbiotic biofilm and characterized by the progressive destruction of the toothsupporting tissues. Among the mediators involved in its pathogenesis, matrix metalloproteinase-9 (MMP-9) stands out as an enzyme associated with extracellular matrix degradation and the progression of periodontal tissue destruction. Objective: To analyze MMP-9 levels in the gingival crevicular fluid of adult patients with periodontitis undergoing non-surgical periodontal therapy through full-mouth ultrasonic debridement without the use of adjunctive antimicrobial agents, as well as to evaluate its association with clinical periodontal parameters. Methodology: This longitudinal study included a convenience sample of 20 patients treated at the Dental Clinic of the Federal University of Maranhão (UFMA). The clinical parameters probing depth (PD) and clinical attachment level (CAL) were assessed to establish periodontitis staging as stages I, II, and III, based on an adapted form of the classification proposed by Tonetti et al. (2018). Gingival crevicular fluid (GCF) samples were collected from three sites per participant, including two diseased sites (PD ≥ 4 mm) and one healthy site, all interproximal and nonadjacent. MMP-9 concentration was determined using the enzyme-linked immunosorbent assay (ELISA) and evaluated at baseline, 24 hours, and 60 days after non-surgical periodontal therapy through full-mouth ultrasonic debridement without the use of adjunctive antimicrobial agents. Statistical analysis was performed using the D’Agostino–Pearson, Kruskal–Wallis, Dunn, one-way ANOVA, Sidak, and Holm–Sidak tests, adopting a significance level of 5%. Results: Higher values of probing depth, clinical attachment level, and MMP-9 were observed in the more advanced stages of periodontitis. Following non-surgical periodontal therapy, a reduction in clinical parameters was observed across all stages, with a more pronounced and statistically significant decrease (p < 0.05) in stage III. Regarding MMP-9, a progressive reduction in its levels was observed over time, particularly in stages II and III, with a statistically significant difference (p < 0.05) at 60 days compared with baseline. Conclusion: Nonsurgical periodontal therapy through full-mouth ultrasonic debridement was effective in improving clinical periodontal parameters and reducing MMP-9 levels after 60 days. Furthermore, an association was observed between clinical parameters and the levels of this enzyme, indicating its potential as a complementary biomarker for assessing inflammatory activity and monitoring the response to non-surgical periodontal treatment.