Interdisciplinary Assignment and Cooperation

PerioPrevention Centers (PPC) are centers of expertise for oral prevention therapies. They benefit from our strong network of not only specialist medical practices but also prevention and check-up centers that need to partner with dental clinics in order to care for their patients. Conversely, our PPCs are able to make use of the additional expertise gained by working with medical specialists. aMMP-8 is the diagnostic link that makes interdisciplinary communication far easier and promotes an understanding of the connection between oral and physical health.

The Specialist Initiative

Building the Bridge from Medicine to Dentistry

Building the bridge from medicine to dentistry is Europe’s biggest interdisciplinary initiative by medical specialists to have combined the early detection and prevention of oral inflammatory processes.

In line with the demands of the German Dental Association (Bundeszahnärztekammer – BZÄK) and leading specialist associations for preventive medicine for cooperation in order to drive the prevention of periodontal inflammation processes, an interdisciplinary action alliance has been created.

Here, you can obtain a specific overview that will familiarize you with the network of medical specialists who are using preventive medicine in an interdisciplinary manner.

The guiding principle “Healthy Mouth – Healthy Body” forms the core of our philosophy. The focus is always on patient well-being and the preservation of inflammation-free oral and physical health. At the same time, your clinic benefits from the opportunity to strengthen its preventive services.

Expert Statements: Combined Knowledge, Interdisciplinary Thinking, and Cooperative (Re)actions

The Interdisciplinary Linking of Medicine and Dentistry – The PPC Referral Concept

Leading specialists recommend interdisciplinary cooperation between the medical and dentistry sectors and want to work with dental hygiene clinics that focus on prevention. aMMP-8 brings together the fields of medicine and dentistry. Below, you will find statements from experts from a wide range of disciplines…

Dentistry

Prof. Inv. Dr. Martin Jörgens

Periodontitis has far-reaching implications in areas that are very serious from a medical perspective. The aMMP-8 biomarker technology enables us to monitor the progression of diseases. Working with medical specialists from other disciplines should be standard practice.

Gynecology

Dipl. med. Kersten Marx

We look to work with dentists so that we can progress people’s desire to have children. The occurrence of periodontal diseases should be reduced.

Family Planning

Najib N. R. Nassar

The average age of first-time mothers is continually rising. As too is the number of cases of periodontitis, which in turn have a negative effect on fertility.

Diabetology

Prof. Dr. Dr. Andreas Pfützner

In the case of medical conditions like diabetes, we need sensible, integrative patient care.

Preventive Medicine

Prof. Dr. med. Bernd Kleine-Gunk

Interdisciplinary work is always important in medicine. To optimally look after people’s overall health, we need more dentists.

Gynecology

Dr. med. Jürgen Klinghammer

Silent inflammation puts great strain on good health and restricts women’s fertility. The same applies with regard to the immune system and chronic diseases. Interdisciplinary cooperation is the future and we depend on the creation of an interdisciplinary network of doctors and, in particular, dentists.

Neurosurgery

Andreas Schmitz

Interdisciplinary cooperation is extremely important to us. We work with a dental professional and have recorded some excellent successes as a result. He helps us choose the correct implant surgery. Any silent oral inflammation must first be eliminated before surgical interventions can occur.

Traumatology

Prof. Dr. med. Burkhard Rischke

The cooperation between the two disciplines is a key milestone in the future direction of modern medicine and represents a responsible, patient-oriented approach. We have to develop further through the use of screening methods and with the involvement of dentists to eliminate silent oral inflammation, which regularly influences other complex diseases.

Speaking the Same Language

The Diagnosis that Connects Us

Periodontitis is the most severe of all silent inflammation processes that can negatively affect our general health, including by triggering chronic diseases. Previously, doctors were unable to diagnose this problem. Prof. Dr. Timo Sorsa from the University of Helsinki has researched aMMP-8 biomarker technology within the scope of an over-30-year research project and scientifically proven the validity and reliability of this test procedure in over 200 studies.

aMMP-8 is regarded as the bridge between the fields of medicine and dentistry, and enables doctors and dentists, for the first time, to identify the degenerative degradation of the periodontium by means of a biomarker value measurable in saliva before externally visible damage occurs.

Biomarker diagnostics – the language of medicine: aMMP-8 is an indicator of active periodontal degeneration (APD) and forms the basis of the communications within the interdisciplinary team of practitioners.
Similarly to CRP in serum, with aMMP-8, there is now a reliable biomarker that can be used to detect whether the immune system is already breaking down periodontal tissue by activating the oral matrix metalloproteinases and whether a subclinical inflammatory process is present.

Not yet visible to the naked eye, this acute process accelerates the reduction in tissue stability and thus the loss of strength of the periodontium. In addition, at this point, silent inflammation is already putting strain on the immune system. For healthy people, this represents a weakening of the body’s own defenses; for people with a chronic condition, it is a further negative influence on existing ailments (diabetes, rheumatism, etc.).

Early detection using aMMP-8 biomarker diagnostics now enables doctors and dentists to communicate with each other on the basis of a measurable value in order to protect their joint patients against the potential negative influences of silent oral inflammation at the earliest possible stage.

aMMP-8 – Interdisciplinary Approach

The Connection between the Mouth and the Body

Collagenases, such as aMMP-8, can be found in almost all areas of the human body. They are required for physiological remodeling processes, e.g. for developing an embryo, nerve growth, or angiogenesis. MMPs are also involved in most pathological processes, including in arthritis, tumor diseases, cardiovascular diseases, wound healing, and periodontitis.

As soon as the periodontal tissue starts an inflammatory reaction, the immune cells activate and secrete the enzyme MMP-8. This cleaves the dense network of collagen fibers to enable defense cells to move to the infection site. Like a “machete in the collagen jungle” aMMP-8 clears a path for granulocytes, macrophages, and osteoclasts.

If this process is thrown out of balance, e.g. due to chronic stimulation, smoking, stress, hormonal changes, or diabetes, this can result in increased – and under certain circumstances periodontal – tissue degradation. The previously dense barrier becomes more permeable and can therefore provide a point of entry into the bloodstream for oral microorganisms and inflammatory messengers.* This can result in chronic subclinical bacteremia, i.e. the temporary presence of bacteria in the bloodstream that is impossible or difficult to clinically detect. Evidence of oral bacteria has been found in clinical studies, e.g. in atherosclerotic plaque but also on joint prostheses.

Prevention is Key

aMMP-8 Analysis for Dentistry and Medicine

Two test versions are available to you for the aMMP-8 analysis. Depending on the situation at hand, a digital analysis can be performed using the PerioSafe PRO DRS test, a mouth rinse test – as a screening for all natural teeth to diagnose collagen degradation in seemingly healthy patients at an early stage. For patients already identified as having periodontitis, the test can be directly performed on the specific tooth or implant using ImplantSafe DR to prevent these patients from experiencing new cases of collagen degradation and therefore protect the stability of the teeth in the bone.

To protect your patients against negative interactions between oral “silent inflammation” and an unfulfilled desire to have children, diabetes, rheumatism, COPD, or a heightened risk of heart attack or stroke, this analysis is also conducted in experienced specialist medical practices and family planning centers using the PerioSafe PRO DRS + ORALyzer in order to provide a quantitative result.

With your patient’s consent, you can use the APD advice form and personalized prevention plan to analyze readings and develop an interdisciplinary treatment plan in cooperation with specialist medical colleagues.

Quantitative Analysis with the ORALyzer

Digital – Quantitative – Chairside

  • Detects active collagen degradation
  • Is simple to perform
  • Provides a quantitative result in just a few minutes
  • Is validated and reliable
  • Is delegable and privately billable
  • Is suitable for use in both dental clinics and medical practices, thereby enabling interdisciplinary diagnosis and treatment

Start the video

The Personalized Prevention Plan with Declaration of Consent 

The Best Protection Against Periodontitis

 The earlier a hidden inflammation can be detected, the easier it will be to treat. What’s more, the earlier the affected areas of the implant and periodontium are specifically and professionally treated, the higher the chances that the patient will make a full recovery. Therefore, every opportunity for early detection and prophylaxis should be utilized to ensure that complications or implant loss can be combated through treatment at an early stage. However, it is not possible to distinguish healthy from unhealthy peri-implant tissue using probing or pocket-depth measurement alone.

Enhance Existing Diagnostics with the PerioSafe PRO DR
The aMMP-8 technology used in the PerioSafe Digital Reader System is two to three times more sensitive than the standard “bleeding on probing” (BOP) procedure, enabling a reliable quantitative assessment of periodontal “grading” – a key progression parameter.

ImplantSafe® DR offers fast quantitative detection of the risk of peri-implantitis and its progression for each and every implant. There’s no waiting for test results to come back from a lab.

Instant digital analysis enables rapid visualization of the measurement, which in turn helps raise awareness among dental implant patients and motivate them to take preventive action. 

Declaration of Consent in the Prevention Plan
The Declaration of Consent, which was developed with leading lawyers, provides you with the forensic documentation you require and explains to patients the importance of attending preventive checkup at the recommended intervals.

Center of Expertise for the Preservation of Natural Teeth, Implant Protection, and Molecular-Biological Preventative Diagnostics

The PerioPrevention Concept

Almost half of all adults in Germany are diagnosed with moderate periodontitis (grade 3) (DMS-V). Experts estimate that around 28 million German adults are in need of periodontal treatment. And yet only around one million treatments for periodontal disease were claimed from statutory health insurance companies in 2016.

In other words, only 3 to 4% of those affected are receiving suitable treatment. This discrepancy may possibly be explained by the fact that the early stage of periodontal degradation is not be detected in time or that the necessary treatment is not pursued.

PerioPrevention Centers (PPC) are dental practices and clinics that are particularly committed to the preservation of natural teeth and implant protection, and have specialized in these areas. They use aMMP-8 biomarker technology for screening and monitoring processes as standard and are the first point of call in their region for interdisciplinary cooperation with medical specialists. PCCs have the expertise and equipment needed to use modern diagnostics and minimally invasive measures to prevent the development of periodontal diseases at an early stage and sustainably eliminate them. The interdisciplinary PPC prevention strategies include:

  • Early detection of active collagen degradation using a quantitative test/laboratory test (PerioSafe PRO DR/ImplantSafe DR & ORALyzer) as diagnostic standard practice
  • Creation of a personal prevention plan and recording of the quantitative MMP-8 input value. Professional teeth cleaning (PTC) with pocket decontamination or deep cleaning plus advice on dental care at home (needs-oriented)
  • PerioPrevention concept – according to a Swedish long-term study, regular professional teeth cleaning is the best way to achieve successful long-term results. The 25-year study by Axelsson & Lindhe therefore recommends that patients start by having their teeth professionally cleaned 4–6 times per year for the first 24 months. The frequency can then be reduced to 2–4 times per year.
  • Clinical monitoring and quantitative control with aMMP-8 for progression monitoring purposes plus a treatment and recall decision based on diagnostics
  • Interdisciplinary consultations with the medical specialists treating the patient, if necessary

The PerioPrevention Concept According to Axelsson and Lindhe
As a result of their 25-year study, the Swedish researchers Axelsson and Lindhe recommend that patients have their teeth professionally cleaned 4–6 times a year for the first two years. The frequency can then be reduced to 2–3 times per year. This would make it possible to reduce the number of teeth lost by 90% to approx. 1.4.

Early Detection of PA Progression

Implant Protection and Preservation of Natural Teeth

Almost half of all adults in Germany are diagnosed with moderate periodontitis (grade 3) (DMS-V). Experts estimate that around 28 million German adults are in need of periodontal treatment. And yet only around one million treatments for periodontal disease were claimed from statutory health insurance companies in 2016.

In other words, only 3 to 4% of those affected are receiving suitable treatment. This discrepancy may possibly be explained by the fact that the early stage of periodontal degradation is not be detected in time or that the necessary treatment is not pursued.

By the time they reach retirement age, Germans lose approx. 14 teeth (according the DMS IV). In most cases, tooth loss results from the unnoticed progression of silent periodontal inflammation, the frequency of which has also increased by around 23%.

The PerioPrevention Concept is developed in line with the scientific principles established by the Universities of Gothenburg and Helsinki according to Axelsson/Lindhe and based on more than 30 years of research and science. It confirms that with early detection and prevention, silent inflammation and tooth loss caused by periodontitis can be reduced by almost 90%.

aMMP-8 Detects which Patients are Experiencing PA Progression

PSI
measures the attachment loss that has already occurred – pocket depth (damage measurement)

MMP-8
measures the active tissue degeneration and has a prognostic value

PA progression
is not visible to the naked eye as it is a molecular process of the immune system

The PerioPrevention Concept

A Strong Team for Oral and Physical Health

Almost half of all adults in Germany are diagnosed with moderate periodontitis (grade 3) (DMS-V). Experts estimate that around 28 million German adults are in need of periodontal treatment. And yet only around one million treatments for periodontal disease were claimed from statutory health insurance companies in 2016.

In other words, only 3 to 4% of those affected are receiving suitable treatment. This discrepancy may possibly be explained by the fact that the early stage of periodontal degradation is not be detected in time or that the necessary treatment is not pursued.

Do you recognize your clinic’s own philosophy and want to integrate the medical biomarker technology as standard so that you, too, can communicate with medical specialists and keep your patients healthy in an interdisciplinary manner?

Then join a pan-European network in the fight against periodontitis and peri-implantitis and for the preservation of oral and physical health.

Become a PerioPrevention Center and Receive your Quality Seal

The PPC quality seal (Perio Prevention & Oral Anti-Aging Center) is the mark of quality for dental clinics that specially focus on prevention and are certified in the area of immunological diagnostic technology.

More than 300 PPCs across Europe use the latest saliva diagnostic technology to guarantee the best possible preservation of natural teeth, protection of implants, and maintenance of general health.