Metalloproteinases in the pathogenesis of periodontal diseases.

Matrix metalloproteinases are produced by both defense and structural cells of the periodontium. They are capable of a wide range of interstitial tissue degradation activities. Complex regulating mechanisms include cytokine regulation of genetic transcription, secretion in latent form, which requires activation once produced, and inhibition by specific inhibitors. It appears that these proteinases and their inhibitors, regulating molecules, and associated genetic material are all potential diagnostic markers of periodontal disease. In addition, they can be measured from gingival crevicular fluid or whole saliva. Generally, high inhibitor levels indicate health, and high levels of metalloproteinase indicate disease. Metalloproteinases can also be inhibited by the tetracycline family of drugs to produce clinical benefits. The diagnostic and therapeutic potential of matrix metalloproteinases and their central role in the pathogenesis of periodontal disease serve to emphasize their importance to periodontologists.