Keywords
MMP-9
Biomarkers
Saliva
Gingival Crevicular Fluid
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To synthesize information on the biological importance of matrix metalloproteinase-9 (MMP-9) in periodontal disease, discussing its role in the pathophysiology of periodontitis, its potential as a biomarker, and perspectives for its clinical application. Literature review: The available evidence demonstrates that MMP-9 participates in the degradation and remodeling of periodontal tissues and is found at significantly elevated levels in the saliva, gingival crevicular fluid, and periodontal tissues of individuals with periodontitis, with reduced levels following periodontal therapy. These findings support its potential as a biomarker of inflammatory activity and treatment response. However, methodological heterogeneity among studies, the lack of standardized protocols for its quantification, and the absence of clinically validated reference values still limit its application in clinical practice. Final considerations: MMP-9 plays an important role in the pathophysiology of periodontitis and has potential as a complementary biomarker for the diagnosis and monitoring of periodontal disease. However, its incorporation into clinical practice depends on prospective, multicenter, and methodologically standardized studies capable of validating its clinical applicability.
References
ALARCÓN-SÁNCHEZ MA, et al. Levels of IL-1β, MMP-8, and MMP-9 in the saliva of subjects with periodontitis: a systematic review and meta-analysis. Journal of Clinical Laboratory Analysis, 2025; 39(10): e70040.
ATARCHI AR. Potential of salivary matrix metalloproteinase-9 to discriminate periodontal health and disease. Journal of Baghdad College of Dentistry, 2022; 34(2): 74-79.
BAYIRLI AB, et al. Evaluation of salivary melatonin and MMP-9 levels in periodontal diseases. Archives of Oral Biology, 2025; 169: 106116.
BOELEN GJ, et al. Matrix metalloproteinases and inhibitors in dentistry. Clinical Oral Investigations, 2019; 23: 2823-2835.
CATON JG, et al. A new classification scheme for periodontal and peri-implant diseases and conditions: introduction and key changes from the 1999 classification. Journal of Clinical Periodontology, 2018; 45(Suppl 20): S1-S8.
FRANCO C, et al. Matrix metalloproteinases as regulators of periodontal inflammation. International Journal of Molecular Sciences, 2017; 18(2): 440.
GHOSH P, et al. Expression of matrix metalloproteinase-9 in gingival tissue biopsy in patients with slowly/moderately and rapidly progressing periodontitis: an observational study. Journal of Indian Society of Periodontology, 2021; 25(5): 386-392.
ISOLA G, et al. Impact of matrix metalloproteinase-9 during periodontitis and cardiovascular diseases. Molecules, 2021; 26(6): 1777.
KIM KA, et al. Correlation of expression and activity of matrix metalloproteinase-9 and -2 in human gingival cells of periodontitis patients. Journal of Periodontal & Implant Science, 2013; 43(1): 24-29.
KÖKSAL C, et al. Salivary galectin-7, galectin-10, and MMP-9 levels in periodontally healthy, gingivitis, and periodontitis patients. Journal of Periodontology, 2026; 97(5): 907-918.
LIMA KM, et al. MMP-8 in periodontal sites of postpartum and without-any-pregnancy women. International Journal of Environmental Research and Public Health, 2024; 21(6): 739.
LUCHIAN I, et al. The role of matrix metalloproteinases (MMP-8, MMP-9, MMP-13) in periodontal and peri-implant pathological processes. International Journal of Molecular Sciences, 2022; 23(3): 1806.
LUCHIAN I, et al. Using salivary MMP-9 to successfully quantify periodontal inflammation during orthodontic treatment. Journal of Clinical Medicine, 2021; 10(3): 379.
MARCACCINI AM, et al. Gingival crevicular fluid levels of MMP-8, MMP-9, TIMP-2, and MPO decrease after periodontal therapy. Journal of Clinical Periodontology, 2010; 37(2): 180-190.
PAN W, et al. The cytokine network involved in the host immune response to periodontitis. International Journal of Oral Science, 2019; 11(3): 30.
RYAN ME, GOLUB LM. Modulation of matrix metalloproteinase activities in periodontitis as a treatment strategy. Periodontology 2000, 2000; 24: 226-238.
SÖDER B, et al. Levels of matrix metalloproteinases-8 and -9 with simultaneous presence of periodontal pathogens in gingival crevicular fluid as well as matrix metalloproteinase-9 and cholesterol in blood. Journal of Periodontal Research, 2006; 41(5): 411-417.
SORSA T, et al. Matrix metalloproteinases in periodontal and peri-implant diseases: contribution to their pathogenesis, diagnosis, and treatment. Journal of Periodontal Research, 2026; 61(4): 355-371.
TONETTI MS, et al. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. Journal of Clinical Periodontology, 2017; 44(5): 456-462.
ZHANG H, et al. MMP9 protects against LPS-induced inflammation in osteoblasts. Innate Immunity, 2020; 26(4): 259-269.