A Case-Control Study on the Association Between Periodontal Health and Gingival Crevicular Level of Matrix Metalloproteinase-8 in Post COVID-19 Patients

Periodontitis is a serious problem disease due to its extensive prevalence. The most common definition of Periodontitis is a chronic inflammatory disease associated with many factors linked with plaque formation and characterized by the first clinical sign which is clinical attachment loss (CAL) and alveolar bone loss in a radiograph.

Initiation of periodontitis and progression depends on dysbiotic changes in the gingival sulcus microbiome in response to inflammation which activates of many molecular pathways, that result in loss of marginal periodontal ligament fibers, and apical migration of the junctional epithelium, which allows the bacterial biofilm to diffuse apically along the root surface.

Periodontitis is dependent on a number of origins but the main responsible is the dental plaque, While the progression is affected by the host response to local factors like plaque and calculus, genetics, environmental factors, systemic health, lifestyle habits, and various social determinants also play a role.

The etiology of periodontitis is the host periodontal tissues exposure to oral bacteria (including polymicrobial synergy, viruses, fungi, and parasites) that accumulate in oral biofilms, known as dental plaque, due to a lack of appropriate oral hygiene, which refers to a proper environment to retract inflammation products as polymorphonuclear, neutrophils, pro-inflammatory cytokines, matrix metalloproteinases, and reactive oxygen species, leading to gingivitis, when it is not treated well; a host immune system response is triggering progressing to periodontitis, in this case, other factors will act as progression more important than dental plaque, that means periodontitis is polymicrobial, multifactorial disease.

In a healthy periodontium, there is a microbial balance in the biofilm but when this balance is lost, increasing acid-producing concentrations and acid tolerating bacteria is a result in dental biofilm.