Qian Yang, Yuyan Wu, Li Li, Shixun Ma, Kangle Guo, Mingxia Cheng
MMP-8 and IL-1β demonstrate moderate-to-good diagnostic accuracy for peri-implantitis, supporting their potential role as adjunctive diagnostic tools. However, substantial heterogeneity, lack of standardized cutoff thresholds, and the presence of publication bias limit the certainty of evidence. Further prospective studies with standardized methodologies and externally validated thresholds are warranted before clinical implementation.
BACKGROUND: Although MMP-8, IL-1β, and IL-6 have been implicated in peri-implantitis, their diagnostic accuracy for detecting peri-implantitis has not been systematically quantified. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of matrix metalloproteinase-8 (MMP-8), interleukin-1β (IL-1β), and interleukin-6 (IL-6) for the detection of peri-implantitis, and to compare their levels between peri-implantitis patients and healthy controls.
METHODS: A comprehensive literature search was conducted across English and Chinese Database up to May 1st, 2026. Studies reporting diagnostic accuracy data or biomarker concentrations for MMP-8, IL-1β, or IL-6 were included. Pooled standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Diagnostic performance was assessed to pool sensitivity, specificity, likelihood ratios, diagnostic odds ratio, and area under the curve (AUC). Heterogeneity was evaluated using I² statistics, and publication bias was assessed using Egger's test.
RESULTS: Twenty-five studies were included. Meta-analysis showed significantly elevated levels of MMP-8 (SMD = 1.80; 95% CI: 0.88-2.71), IL-1β (SMD = 2.07; 95% CI: 1.36-2.78), and IL-6 (SMD = 1.53; 95% CI: 0.89-2.17) in peri-implantitis patients compared to healthy controls. For diagnostic accuracy, MMP-8 demonstrated a pooled sensitivity of 0.83 (95% CI: 0.76-0.98), specificity of 0.80 (95% CI: 0.61-0.91), and AUC of 0.84 (95% CI: 0.80-0.87). IL-1β showed a sensitivity of 0.72 (95% CI: 0.63-0.80), specificity of 0.75 (95% CI: 0.67-0.81), and AUC of 0.79 (95% CI: 0.75-0.82). Leave-one-out sensitivity analyses confirmed the robustness of all pooled estimates.
CONCLUSIONS: MMP-8 and IL-1β demonstrate moderate-to-good diagnostic accuracy for peri-implantitis, supporting their potential role as adjunctive diagnostic tools. However, substantial heterogeneity, lack of standardized cutoff thresholds, and the presence of publication bias limit the certainty of evidence. Further prospective studies with standardized methodologies and externally validated thresholds are warranted before clinical implementation.