Abstract
To determine the diagnostic value of inflammatory cytokines in periodontal disease, we performed a systematic review of the changes in inflammatory cytokines after non-surgical periodontal therapy and a meta-analysis of the utility of interleukin (IL)-1β and matrix metalloproteinase (MMP)-8 as salivary biomarkers. All available papers published in English until 20 August 2020, were searched in the MEDLINE and EMBASE databases. Population, intervention, comparison, and outcome data were extracted from the selected studies, and the roles of IL-1β and MMP-8 were assessed in a meta-analysis. Eleven studies, including two meta-analyses, were assessed in the systematic review. Biomarkers showing high levels in periodontal disease were salivary IL-1β, IL-4, IL-6, MMP-8, and tissue inhibitor of matrix metalloproteinases (TIMP)-2, and those in the controls were tumor necrosis factor (TNF)-α, IL-10, IL-17, and IL-32. Biomarkers that decreased after scaling and root planning (SRP) and oral hygiene instruction (OHI) in periodontitis patients were IL-1β, MMP-8, MMP-9, prostaglandin E2 (PGE2), and TIMP-2. The pooled standardized mean difference of IL-1β and MMP-8 was −1.04 and 35.90, respectively, but the differences between periodontitis patients and healthy controls were not significant. Although the changes in salivary IL-1β and MMP-8 levels after non-surgical periodontal therapy were not significant, salivary cytokines could be used to confirm the effect of periodontal therapy or diagnose periodontal disease.
Highlights
Periodontal disease is the most common bacterial infection worldwide
Gingivitis is confined to the gingiva, which can be returned to the healthy state by appropriate oral health management, while periodontitis represents an irreversible stage that is difficult to restore to the previous healthy state since the inflammation has spread to the alveolar bone and periodontal tissue [3,5]
The authors followed criteria established in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this review [31], and it aimed to analyze the salivary cytokine content in relation to periodontal disease and evaluate alterations in salivary biomarker levels in relation to periodontal disease after non-surgical periodontal therapy
Summary
Periodontal disease is the most common bacterial infection worldwide. It occurs mainly in adults, and a large population of people aged 30 years or older show this disease [1]. As the condition progresses to periodontitis, the second stage, inflammation, is not confined to the gingiva and spreads to the periodontal tissue, including the periodontal ligament and alveolar bone. Gingivitis is confined to the gingiva, which can be returned to the healthy state by appropriate oral health management, while periodontitis represents an irreversible stage that is difficult to restore to the previous healthy state since the inflammation has spread to the alveolar bone and periodontal tissue [3,5]. Periodontitis is a risk factor for the development of osteonecrosis of the jaws in patients taking antiresorptive
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