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

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 multiply globally 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. This special report considers a combination of mouthrinse aMMP-8 and calprotectin in periodontitis disease diagnostics at the dentist's office for simultaneously identifying at-risk patients of diabetes and CVD reviewing recent PubMed indexed findings comparing disease diagnostics by aMMP-8 and calprotectin individually and combined. By combining CCAA-DPRs analysis with oral fluid mouthrinse aMMP-8 and calprotectin lateral-flow immunoassays as point-of-care/chair-side testing's, especially by the polynomial-algorithm-machine-learning technology (including computer vision), can provide a modern noninvasive, safe, economical diagnostic AI-tool. This tool can be utilized for on-line real-time screening of the interlinked processes involving stroke-, CVD-, diabetic- and periodontal disease cascades. Accordingly, identified at-risk patients are then referred for necessary medical and dental interventions.