This document discusses the role of matrix metalloproteinase 2 (MMP-2) in chronic periodontitis. MMP-2 is a gelatinase found in gingival crevicular fluid and periodontal tissue that can degrade proteins and collagen fibers. Increased levels of MMP-2 may be associated with the symptoms of chronic periodontitis such as inflammation, tissue destruction, and tooth mobility. Quantifying MMP-2 levels in gingival crevicular fluid could help diagnose chronic periodontitis and monitor the effects of treatment. Natural compounds that inhibit MMP-2 may offer alternative therapies to antibiotics for treating chronic periodontitis.

1. The role of matrix metalloproteinase 2
(MMP-2 ) in chronic periodontitis
Speaker: Yeh Feng-wei
Tutor: Maria Amparo

2. SPEAKER: YEH FENG-WEI
TUTOR: MARIA AMPARO VILA CABALLER
The role of matrix metalloproteinase 2
(MMP-2 ) in chronic periodontitis
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3. What is the function of MMPs in our body?
• Matrix metalloproteinase is like a worker also the body guard.
• When our bodies get into some trouble, they will call the security to
resist the foreign enemy.
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4. MMPs (Matrix metalloproteases)
• MMPs are proteases which are found in combination with Zn2+
metal
ions.
• They are capable of degrading all types of extracellular matrix
proteins, but also can process a number of bioactive molecules (such
as; fibrocartilage degradation).
• MMPs are a group of enzymes that in concert are responsible for the
degradation of most extracellular matrix proteins during
organogenesis, growth and normal tissue turnover.
• MMP-2 plays an important role in fibrocartilage degradation in
internal derangement of the mandibular joint.
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5. MMP-2
• is present on the cartilage and in synovial fluid
• is a gelatinase
• MMP-2 allows living organisms to hydrolyse gelatin into its sub-
components (polypeptides, peptides and amino acids).
– You can detect MMP-2 by Immunostaining: A positive signal was
observed in the cytoplasm of chondrocytes and in their
surrounding matrix.
– ELISA
– 2D electrophoresis
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6. Periodontitis
• Periodontitis is a progressive disease of the tooth supporting
apparatus affecting gingiva, periodontal ligament, root cement and
alveolar bone.
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7. Chronic periodontitis
• A common, painless, slow progressing disease, characterized by specific
clinical features:
– Gingival inflammation
• § Bleeding on probing (BOP)
• § Loss of clinical attachment
• § Loss of alveolar bone
• § Periodontal pocket (>3mm)
– Variable features include:
• § Gingival enlargement
• § Gingival recession
• § Root furcation involvement
• § Tooth drifting
• § Tooth exfoliation
• § Tooth mobility
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8. Classification of periodontitis
• According to “Classification of periodontal diseases and conditions,
Armitage,1999” and be further classified on the basis of extent and
severity.
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9. Possible role of mmp-2 in chronic periodontitis?
• MMP-2 is present in the synovial fluid junction
(periodontal ligament) and cartilage, and degrades protein
and collagen fibers.
• Chronic periodontitis symptoms include
– Inflammation caused by MMP-2, MMP-8 AND MMP-9
– Tooth mobility caused by MMP-8 and MMP-9
• Due to the gelatinase function of MMP-2, we hypothesize
that MMP-2 may also be associated with tooth mobility
caused by periodontitis
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10. Smoking and Periodontitis
• Smoking is one of the main modifiable risk factors for chronic
periodontitis.
– Smokers tend to have poorer periodontal health and a poor
response to periodontal treatment.
– Approximately half as much improvement following surgical or
non-surgical therapy.
– Surgical therapy is used by tetracycline or doxycycline with root
planning surgery treatment.
• Tetracycline or doxycycline can inhibit MMPs to decrease
inflammation of periodontal tissue, functioning as tissue inhibitors of
metalloproteinases (TIMP).
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11. Clinical trail patients selection:
• According to “Classification of periodontal diseases and conditions,
Armitage,1999”(table 2).
• In Chronic periodontitis patients who have the syndrome of Blood of
probing (BoP), Localized sites (≤30% sites) the amount of clinical
attachment loss (CAL) more than 1 or 2mm CAL are selected and
classified the smoking or non-smoking people groups.
• There are 3 groups to identify the patient according to the dosage.
1. More than 10 cigarettes per day.( Group 1)
2. Lower than 10 cigarettes per day (Group 2)
3. Non-smoking patients. (Group control)
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12. Methodology:
• The article review is about Chronic periodontitis and MMP-2 assay
from 1991 to 2012 in the data base (SAGE journals and NCBI
pubmed).
• 83 articles were found, and 60 articles were excluded, 23 articles
from 1991 to 2012 were included. One Chinese studies with English
outline was included.
• Inclusion criteria is the language included English and Chinese both
and the outline from 1991 to 2012 and be realized the relation
between MMP-2 assay and Chronic periodontitis.
• Exclusion criteria; some studies which don’t support the relation
between periodontal problem with MMP-2 strongly are excluded.
Also the outline wasn’t showed the gelatinase specifically was
excluded.
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13. Discussion
• MMP-2 is correlated with chronic periodontitis, because as a
gelatinase, thus, it can hydrolyze cartilage tissue and make tooth
ligament decrease. Tooth mobility are cause because of the decrease
of tooth ligament. Therefore in Chronic periodontitis treatment,
dentists use antibiotics e.g. Tetracycline and Doxycycline.
• In cosmetic market there are a lot of natural compounds developed
for decrease MMP-2 on the skin or soft tissue of face. e.g. Q10 co-
factor, 3’, 4’, 7-Trihydroxyflavone. It will avoid collagen fiber
breakdown on the skin and then Anti-wrinkle.
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14. Alternative periodontitis therapy of antibiotics
• To develop another alternative way for chronic periodontitis therapy,
to discover another natural compound with less or without side effect
will make chronic periodontitis patient have a good life quality and
according to MMP-2 values examination to make the treatment plan
with the compound which can make inhibition of MMP-2 after usual
periodontal treatment will decrease the antibiotics use.
e.g. Tetracycline , doxycycline. For example , tetraxcycline will make
fluorosis or some severe fugal infection patients who can’t prescribe
antibiotics.
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15. Tetracycline, MMPs and Gingival cervical fluid
• Tetracycline are effective in suppressing the Gram-negative
periodontopathic organisms in the subgingival plaque and tetracycline
have the ability among antibiotics to concentrate in the gingival
crevicular fluid (GCF) of the periodontal pocket at levels 5-10 times
greater than those found in serum.
• In present study, there are a lot of method to analyze MMPs with
Zymography combined specific western blotting and ELISA. It’s more
precise and sensible than only zymography or ELISA.
• Therefore to detect MMPs values in GCF with Zymography combined
specific ELIZA is more precise than only use Zymography way.
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16. Conclusion
• MMP-2 values would be quantified for ELISA reader and to be a
reference of chronic periodontitis with periodontitis classification.
• Because MMP-2 is a kind of gelatinase, MMP-2 may make the
connective tissue destruction in periodontitis.
• MMP-2 values may be associated with chronic periodontitis.
• GCF can be the indicator of MMP-2 value for periodontitis patients.
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17. Conclusion
• MMPs have a marked role also in tissue destructive oral diseases.
• The role of collagenases, especially MMP-8, in periodontitis and peri-
implantitis is the best-known example of the unwanted tissue
destruction related to increased presence and activity of MMPs at the
site of disease, but evidence has been brought forward to indicate
that MMPs may be involved also in other oral diseases, such as dental
caries and oral cancer.
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18. Conclusion
• According to characteristics of MMP-2 in chronic periodontitis, we
tend to be looking for new diagnosis and treatment for oral surgery
and post-surgery care.
• There are variable natural compounds which have the inhibition of
MMPs.
• It may facilitate the development of new means of diagnosis and
treatment of oral diseases.
• People spend billions of money every year for anti-aging products to
stay young. The key component is anti-aging active ingredients. It
promises to diminish fine lines and wrinkles, abolish sun damage, and
lift sagging part on the face. Hya-Heal+/MMpH+ can inhibit the
activity of certain proteinase therefore reduce degradation of natural
collagen. (ITRI ,Taiwan, 2016)
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19. Thank you very much!!!
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