Biomarkers For Periodontitis Research Articles

Treponema denticola as a prognostic biomarker for periodontitis in dogs.

Periodontal disease is one of the most common disorders in the oral cavity of dogs and humans. Periodontitis, the irreversible periodontal disease, arises progressively from gingivitis, the reversible inflammatory condition caused by dental plaque. Although the etiology of periodontitis has been widely studied in humans, it is still insufficient for the etiological studies on periodontitis in dogs. Many studies have reported that human periodontitis-related bacteria are putative pathogens responsible for periodontitis in dogs. However, most of these studies have focused on the appearance of a specific microbiome, and most of the cohort studies have insufficient sample sizes to generalize their results. In the present study, subgingival samples collected from 336 teeth were categorized into three groups at first, based on clinical outcomes (healthy, gingivitis, periodontitis). Subsequently, the periodontitis samples were further divided into three subgroups (early, moderate, and advanced periodontitis) according to the degree of periodontal attachment loss. Healthy and gingivitis were grouped as a reversible group, and the three subgroups were grouped as an irreversible group. To investigate trends of periodontopathic bacteria in the samples of dogs, a quantitative real-time polymerase chain reaction (PCR) was performed for quantification of 11 human periodontopathic bacteria as follows: Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia, Treponema denticola (Td), Fusobacterium nucleatum, Prevotella nigrescens, Prevotella intermedia, Parvimonas micra, Eubacterium nodatum, Campylobacter rectus, and Eikenella corrodens. The PCR results showed that Aa and Pg, the representative periodontopathic bacteria, were not significantly correlated or associated with the periodontitis cases in dogs. However, interestingly, Td was strongly associated with the irreversible periodontal disease in dogs, in that it was the most prevalent bacterium detected from the dog samples. These findings indicate that the presence and numbers of Td could be used as a prognostic biomarker in predicting the irreversible periodontal disease and the disease severity in dogs.

Transcriptome analysis of Fusobacterium nucleatum reveals differential gene expression patterns in the biofilm versus planktonic cells

As a chronic infectious disease, periodontitis can cause gum recession, loss of alveolar bone, loosening of teeth, and even loss of teeth. Dental plaque biofilm is the initiating factor for the occurrence and development of periodontitis. Fusobacterium nucleatum (F. nucleatum) plays a vital role in the structure and ecology of dental plaque biofilms. It is a bridge between early and late colonization bacteria in dental plaque. Understanding the molecular mechanism of F. nucleatum during biofilm development is essential to control periodontitis. This study aimed to determine gene expression profiles of the F. nucleatum strain, ATCC 25586, in the planktonic and biofilm phase through RNA-sequencing approach. The results were confirmed by quantitative reverse transcriptase PCR (RT-qPCR). The results clearly illustrate the difference in gene expression of F. nucleatum under planktonic and biofilms. A total of 110 genes were differentially expressed by F. nucleatum in the biofilm state compared with the planktonic state. The 25 upregulated genes in the biofilm state were mainly related to carbohydrate and amino acid metabolism, while the 85 downregulated genes were primarily associated with cell growth, division, and oxidative stress; most of the upregulated genes of F. nucleatum involved in virulence and oral malodor. Furthermore, the transcriptome analysis and antibacterial activity test also identified Lysine might exhibit the antibacterial and antibiofilm activity of F. nucleatum for the first time. These new findings could provide caveats for future studies on the regulation and maintenance of plaque biofilm and the development of biomarkers for periodontitis.

Pleckstrin Levels Are Increased in Patients with Chronic Periodontitis and Regulated via the MAP Kinase-p38α Signaling Pathway in Gingival Fibroblasts.

Chronic periodontitis (CP) is a bacteria-driven inflammatory disease characterized by the breakdown of gingival tissue, the periodontal ligament, and alveolar bone, leading ultimately to tooth loss. We previously reported the pleckstrin gene (PLEK) to be highly upregulated in gingival tissue of patients with CP and the only gene concurrently upregulated in other inflammatory diseases including rheumatoid arthritis and cardiovascular diseases. Using saliva from 169 individuals diagnosed with CP and healthy controls, we investigated whether pleckstrin could serve as a novel biomarker of periodontitis. Additionally, we explored signal pathways involved in the regulation of PLEK using human gingival fibroblasts (HGFs). Pleckstrin levels were significantly higher (p < 0.001) in the saliva samples of patients with CP compared to controls and closely associated with CP severity. Immunohistochemical analysis revealed the expression of pleckstrin in inflammatory cells and gingival fibroblasts of CP patients. To explore the signal pathways involved in pleckstrin regulation, we stimulated HGFs with either interleukin-1β (IL-1β) or lipopolysaccharides (LPS) alone, or in combination with inhibitors targeting c-Jun N-terminal kinase, tyrosine kinase, protein kinase C, or p38 MAP kinase. Results showed that IL-1β and LPS significantly increased PLEK mRNA and pleckstrin protein levels. VX-745, the p38 MAP kinase inhibitor significantly decreased IL-1β- and LPS-induced pleckstrin levels at both the mRNA and the protein level. Together, these findings show that pleckstrin could serve as a salivary biomarker for the chronic inflammatory disease periodontitis and a regulator of inflammation via the p38 MAP kinase pathway.

Modernization in assessment of identifying biomarkers for periodontal disease- A review

Modernization in assessment of identifying biomarkers for periodontal disease- A review

Can the delta neutrophil ındex be used as a preliminary biomarker ın the evaluation of periodontal disease: a pilot study.

Objective:Tissue destruction in periodontal diseases is related to inflammatory mediators in the host. However, it is unknown whether a relationship between delta neutrophil index (DNI) and neutrophil-lymphocyte ratio (NLR) in Stage 3 Grade A patients occurs. This cross-sectional study aimed to investigate the relationship between periodontal disease and DNI and NLR.Methodology:The study included 74 systemically healthy, non-smoking adults separated into 3 groups. Group 1: 26 subjects with good periodontal health, Group 2: 26 subjects with gingivitis, and Group 3: 22 subjects with Stage 3 Grade A periodontitis. After determining which group the patient will be included in, a clinical periodontal examination was made of each patient and pocket depth (PD), clinical attachment level (CAL), gingival index (GI), bleeding on probing (BOP) and plaque index (PI) parameters were measured. Venous blood samples were taken and examined with an automatic hematology analyzer for DNI, immature granulocytes (IG), NLR, C-reactive protein (CRP), procalcitonin, neutrophil count and lymphocyte count.Results:DNI, IG, CRP, and neutrophil count were observed to be highest in Group 3, followed by Group 2, and the difference between the groups in these parameters was determined to be statistically significant (p<0.001, p<0.001, p=0.046, p=0.016). DNI, IG, CRP and neutrophil count were observed to be positively correlated with periodontal parameters.Conclusion:The findings of this study support the role of DNI as a new biomarker for periodontal diseases. DNI may better reflect the systemic level of stage 3 grade A periodontitis than traditional inflammatory markers.

Effect of Non-Surgical Periodontal Therapy on Salivary Leptin Levels in Chronic Periodontitis Patients - A Clinico Biochemical Study

Background and aim In patients with periodontitis biomarkers in gingival crevicular fluid saliva and serum plasma have been analyzed. In the assessment of oral diseases particularly periodontal diseases saliva has emerged as a potential diagnostic tool. Salivary leptin concentration has not been analyzed in populations with chronic periodontitis to observe changes regarding the effect of periodontal therapy. Therefore the objective of this in vivo interventional study was to evaluate the effect of non-surgical periodontal therapy NSPT on the levels of leptin in individuals with periodontitis.Methodology Twenty four participants included in the study were divided equally between healthy controls n12 and patients with chronic periodontitis n12. Clinical parameters such as probing depth clinical attachment levels plaque index gingival index and modified sulcular bleeding index were measured. Before and one month after periodontal therapy salivary leptin levels were estimated. Using the student t-test statistical analysis was performed.Results During the assay method leptin was detected in all the 24 patient samples. Between healthy subjects and subjects with chronic periodontitis no statistical significant difference in salivary leptin levels was observed. After NSPT clinical parameter evaluation of patients with chronic periodontitis revealed a significant improvement in the periodontal state. However it is necessary to conduct further interventional research with larger sample to establish the significance of salivary leptin in assessing periodontal health.Conclusion This study concludes that leptin level can be used as a biomarker to evaluate the effectiveness of periodontal therapy in chronic periodontitis patients. To establish a correlation more interventional studies with higher sample size may be required to ascertain the role of salivary leptin in evaluating periodontal health status.

Measurement of Salivary Lipid Peroxidation in Periodontitis Patients with or Without Diabetes Mellitus

Aim: The aim of the present study is to assess the association of lipid peroxidation in the saliva of healthy and periodontitis patients with or without diabetes mellitus.&#x0D; Study Design: Cross-sectional study.&#x0D; Materials and Methods: The study was conducted in the subjects who visited the University dental hospital as outpatients from October 2020 to January 2021.The subjects were categorized into 3 groups: periodontally healthy (Group a), Periodontitis with diabetes mellitus (Group b) and Periodontitis only (Group c)&#x0D; Results: Lipid peroxidation levels were found to be significantly higher (p&lt;0.021 which is statistically significant) in patients with periodontitis and diabetes mellitus (108 + 7.1) when compared to patients with periodontitis only (77 + 3.5) and healthy group (66+5.6).&#x0D; Conclusion: The study concluded that lipid peroxidation levels are elevated in patients with periodontitis and diabetes mellitus compared to periodontitis only and also when compared to periodontal health which indicate that lipid peroxidation levels could serve as a biomarker for periodontitis in diabetic patients.

Quantification of Caspase 3 Levels in Patients with Periodontitis with or without Diabetes Mellitus

Background: Diabetes mellitus is a debilitating systemic disease with several major complications affecting the quality and length of life. Periodontal disease has been considered another diabetic complication in addition to cardiovascular disease, nephropathy, neuropathy, peripheral vascular disease. Caspase-3 plays an important role in intracellular signaling pathways that regulate apoptosis. High levels of glucose could induce human periodontal ligament fibroblast apoptosis.&#x0D; Aim: The aim of the study is to compare caspase 3 levels in periodontitis patients with or without diabetes mellitus.&#x0D; Materials and Methods: 30 patients were included in the study and they are divided into 3 groups: Group a- Periodontal health; Group b- Periodontitis with diabetes mellitus and Group c- Periodontitis patients without diabetes mellitus. Whole unstimulated saliva was collected from 30 patients using expectoration into sterile bulbs. Caspase 3 levels in saliva samples were measured in duplicate using a commercially available Human Caspase-3 (CASP3) enzyme linked immunosorbent assay (ELISA) Kit. Results were analyzed statistically by a one-way analysis of variance (ANOVA) and significant differences between the mean values were measured using Newman-Keuls multiple comparison test using Graph Pad Prism version 5. The results with the p &lt; 0.05 level were considered to be statistically significant.&#x0D; Results: From this study, it was observed that there was a significant increase of caspase 3 levels in periodontitis patients with diabetes mellitus (86.29±24.25 pmol/L) when compared to periodontitis patients without diabetes (55.06±12.90 pmol/L). The results showed a positive correlation and high level of significance when compared between periodontally healthy patients and periodontitis patients along with diabetes mellitus (86.29±24.25 pmol/L). Also, relatively significant results were observed in comparison between periodontally healthy patients (43.37±15.35 pmol/L) and patients with periodontitis without diabetes mellitus (55.06±12.90 pmol/L). Please add the most important statistical values.&#x0D; Conclusion: The present study showed that caspase-3 concentrations in saliva increases in patients with periodontitis complicated along with diabetes mellitus. Moreover, saliva concentrations of caspase-3 increase with periodontal disease and caspase-3 plays a role as a biomarker of periodontal disease and its progression.

Assessment of 8-Hydroxy 2-Deoxyguanosine as Salivary Biomarker for Periodontitis Patients with or without Diabetes Mellitus

Aim: The aim of this study is to assess the levels of 8-hydroxy-2 deoxyguanosine as a salivary biomarker for periodontitis with or without diabetes mellitus.&#x0D; Study Design: Cross-sectional study&#x0D; Materials and Methods: 30 patients were included in the study and were categorised into three groups: periodontal health (Group a), patients with periodontitis without diabetes mellitus (Group b) and patients with periodontitis only (Group c). Unstimulated salivary samples were taken. The OHdG concentration was evaluated using Sandwich-enzyme linked immunosorbent assay by commercially available human OHdG 96 well ELISA kit. The data were statistically analysed by One-Way -ANOVA. The Newman-Keuls multiple comparison test was used to test the significance at the levels of p&lt;0.05.&#x0D; Results: Salivary OHdG concentration in periodontal health, periodontitis with diabetes mellitus (P+DM), Periodontitis only (P) were analysed. Salivary OHdG concentration was found to be significantly higher (p&lt;0.05) in periodontitis with diabetes mellitus (38±2.82 ng/L) when compared with periodontitis only (20.5±2.12 ng/L) and also when compared with healthy controls (11.5±2.12 ng/L).&#x0D; Conclusion: Diabetic patients with periodontitis have increased 8 hydroxy 2 deoxyguanosine than non-diabetic counterparts. Thus salivary 8 hydroxy 2 deoxyguanosine is an effective non-invasive biomarker to assess periodontitis among patients.

Is TIMP-1 a biomarker for periodontal disease? A systematic review and meta-analysis.

ObjectiveOne of the most important families of proteases associated with periodontal disease is the family of the matrix metalloproteinases (MMPs). Their activity is regulated by tissue inhibitors of metalloproteinases (TIMPs), and an imbalance between MMP activity and regulation by TIMPs has been associated with the progression of periodontal disease. This strong interaction between TIMPs and MMPs might be an indication that TIMPs can be used as a biomarker to monitor periodontal disease progression in oral fluids. In particular, TIMP‐1 is a frequently studied biomarker for periodontal diseases. Therefore, the aim of this systematic review was to evaluate the scientific literature regarding TIMP‐1 concentrations in oral fluids of patients suffering from periodontitis or gingivitis in comparison to healthy individuals.Material and MethodsPubMed/ MedLine and Web of Science databases were searched electronically. Studies that met the inclusion criteria were systematically evaluated and assessed for eligibility and risk of bias. Meta‐analysis was performed through the random effects model to assess the association between periodontitis/gingivitis and TIMP‐1 concentration in stimulated saliva, unstimulated saliva, and gingival crevicular fluid (GCF).ResultsThe search strategy provided a total of 322 studies of which 10 studies met all inclusion criteria. Two studies investigated TIMP‐1 concentrations in GCF, three studies in unstimulated saliva, and five studies investigated TIMP‐1 concentrations in stimulated saliva. Three studies revealed that TIMP‐1 levels in oral fluids were significantly decreased in periodontal disease. Meta‐analysis revealed that there is no statistically significant difference between TIMP‐1 concentration in oral fluids of periodontitis/gingivitis patients in comparison to healthy individuals.ConclusionsThis systematic review with meta‐analysis shows that periodontal diseases are not associated with a statistically significant change in TIMP‐1 concentration in oral fluids.

Metabolomic Evaluation of Chronic Periodontal Disease in Older Adults.

Periodontal disease is an infectious inflammatory disease related to the destruction of supporting tissues of the teeth, leading to a functional loss of the teeth. Inflammatory molecules present in the exudate are catalyzed and form different metabolites that can be identified and quantified. Thus, we evaluated the inflammatory exudate present in crevicular fluid to identify metabolic biological markers for diagnosing chronic periodontal disease in older adults. Research participants were selected from long-term institutions in Brazil. Participants were individuals aged 65 years or older, healthy, or with chronic periodontal disease. Gas chromatography/mass spectrometry was used to evaluate potential biomarkers in 120 crevicular fluid samples. We identified 969 metabolites in the individuals. Of these, 15 metabolites showed a variable importance with projection score > 1 and were associated with periodontal disease. Further analysis showed that among the 15 metabolites, two (5-aminovaleric acid and serine, 3TMS derivative) were found at higher concentrations in the crevicular fluid, indicating their potential diagnostic power for periodontal disease in older adults. Our findings indicated that some metabolites are present at high concentrations in the crevicular fluid in older adults with periodontal disease and can be used as biomarkers of periodontal disease.

The emerging role of small extracellular vesicles in saliva and gingival crevicular fluid as diagnostics for periodontitis.

Periodontitis is a highly prevalent multifactorial chronic inflammatory disease associated with a destructive host immune-inflammatory response to microbial dysbiosis. Current clinical diagnosis is reliant on measuring past periodontal tissue loss, with a lack of molecular biomarkers to accurately diagnose periodontitis activity in 'real-time'. Thus, discovery of new classes of diagnostic biomarkers is of critical importance in periodontology. Small extracellular vesicles (<200nm in diameter; sEVs) from oral biofluids (saliva and gingival crevicular fluid-GCF) are lipid-encapsulated bilayered vesicles and have recently emerged as a potential source of biomarkers for periodontal disease (gingivitis and periodontitis), due to the cargo of protein, genetic material and lipids derived from their parent cells. There is limited information on the isolation and characterisation methods of saliva/GCF-sEVs or the characterisation of sEVs cargo as biomarkers for periodontitis. In this review, we detail the composition of sEVs and summarise their isolation and characterisation from saliva and GCF. The potential role of saliva and GCF-derived sEVs in periodontitis diagnosis is also explored. It is proposed that sEVs cargo, including protein, microRNA, message RNA and DNA methylation, are potential biomarkers for periodontitis with good diagnostic power (area under the curve-AUC>0.9).

Comprehensive Analysis of the Mechanism of Periodontitis-Related mRNA Expression Combined with Upstream Methylation and ceRNA Regulation.

Background: Periodontitis is a multifactorial disease mainly caused by the formation of plaque biofilm, which can lead to the gradual destruction of tooth-supporting tissues. Current research on the genetics and epigenetics of periodontitis remains relatively limited, and the molecular mechanisms remain largely unknown. Objective: Our aims were to construct competitive endogenous RNA (ceRNA) network and determine DNA methylation patterns of target genes to help elucidate the pathogenesis of periodontitis. Methods: We analyzed the expression profiles of the GSE16134, GSE54710, GSE10334, and GSE59932 datasets from the Gene Expression Omnibus database through the weighted gene coexpression network analysis system and screened mRNAs that are regulated by the level of methylation and are associated with the occurrence of periodontitis. Next, a lncRNA-miRNA-mRNA ceRNA network was constructed using databases including miRanda and TargetScan. Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were conducted for genes in the clinically significant modules. Finally, a protein-protein interaction network was built. Results: We finally identified four mRNAs, four miRNAs, and six lncRNAs as shared differentially expressed genes related to the periodontitis inflammation pathway. IL-6, IFNA17, CXCL12, and TNFRSF13C were identified as key genes whose expression was significantly enriched in the nuclear factor κB and TLR4 pathways. Moreover, the expression of 28 genes were downregulated by hypermethylation and 70 genes were upregulated by hypomethylation. Conclusions: The constructed ceRNA network can improve our understanding of the pathogenesis of periodontitis. Candidate mRNAs from the ceRNA network could serve as new therapeutic targets and prognostic biomarkers in periodontitis.

Salivary diagnostic biomarker for periodontal disease - A review

Periodontitis is chronic inflammation of the periodontium caused by persistent bacterial infection affecting the connective tissue attachment and supporting bone around the teeth. As the ability to reconstruct the periodontium is limited after alveolar bone loss, early diagnosis and intervention should be paramount goals of periodontal treatment preventing future disease’s progression. Saliva is a physiologic fluid that contains complex mixture of substances as well as inflammatory biomarkers associated with periodontitis. Conventional clinical criteria are often insufficient for determining sites of active disease, for monitoring the response to therapy, or for measuring the degree of susceptibility to future disease progression. Therefore, the use of saliva has provided a substantial addition to the diagnostic armamentarium as an investigative tool for disease processes. With the current technological advances, together with point-of-care detection systems, salivary analysis will be valued much more highly in the near future. Even though saliva is easy to manipulate with low-cost storage, careful attention must be directed to limit variation in specimen integrity. This review focuses on the biomarkers in saliva that appears to be promising in the future for periodontal diagnosis, as well as some contemporary diagnostic tests available.

Spectre de acțiune ale lactoferinei la nivelul cavității orale

Lactoferrin is a cationic glycoprotein found in different compartments of the body and secreted mostly by glandular epithelia and neutrophils. Although initially considered that its functions derive solely from its iron-binding capacity, further research demonstrated the pleiotropic nature of the glycoprotein. Thereby, lactoferrin fulfills various essential physiological functions based on its anti-infectious, immunomodulatory and antioxidative properties. In the oral cavity, lactoferrin is an central component of the local defense mechanisms, and based on its versatility, it can prevent the occurrence and progression of different local pathologies, including periodontitis. Microbiological and inflammatory periodontitis-induced modifications influence the local levels of secreted lactoferrin, the protein becoming a potential diagnosis biomarker of periodontal disease. Moreover, lactoferrin has a potential adjunctive therapeutic benefit in periodontal treatment, based on the interference of the biomolecule with local microorganisms, its anti-inflammatory and antioxidative activity. Additionally, the adverse effects of lactoferrin administration seem less evident as compared to other adjunctive agents. Thus, the present study aims to review the most important characteristics of lactoferrin in different oral pathologies, particularly in periodontitis.

PERIOSTIN – A FORWARD STEP IN PERIODONTAL BIOMARKERS – A NARRATIVE REVIEW

Various biomarkers of periodontal disease are involved in either disease pathogenesis or tissue damage. The main aim of biomarkers research in Periodontology is to provide a significant impact on clinical diagnosis as well as treatment outcomes. Periostin, a microcellular protein is one of the novel biomarkers which is expressed mostly in collagen rich tissues. Its role in systemic health and disease has been studied for many years. Periostin plays a major role in collagen development, cell migration, wound healing and repair and also regulates periodontal pathogenesis. This review focuses on the different aspects of periostin in periodontal health and disease. Keywords: Periostin, Biomarker, Periodontitis, Periodontal regeneration

Potential Roles of the Free Salivary Microbiome Dysbiosis in Periodontal Diseases.

Saliva is a vital mediator in the oral cavity. The dysbiosis of free bacteria in saliva might be related to the onset, development, prognosis, and recurrence of periodontal diseases, but this potential relationship is still unclear. The objective of this study was to investigate the potential roles of the free salivary microbiome in different periodontal statuses, their reaction to nonsurgical periodontal therapy, and differences between diseased individuals after treatment and healthy persons. We recruited 15 healthy individuals, 15 individuals with gingivitis, and 15 individuals with stage I/II generalized periodontitis. A total of 90 unstimulated whole saliva samples were collected and sequenced using full-length bacterial 16S rRNA gene sequencing. We found that as the severity of disease increased, from healthy to gingivitis and periodontitis, the degree of dysbiosis also increased. A higher abundance of Prevotella intermedia and Catonella morbi and a lower abundance of Porphyromonas pasteri, Prevotella nanceiensis, and Haemophilus parainfluenzae might be biomarkers of periodontitis, with an area under curve (AUC) reaching 0.9733. When patients received supragingival scaling, there were more pathogens related to recolonization in the saliva of periodontitis patients than in healthy persons. Even after effective nonsurgical periodontal therapy, individuals with periodontitis displayed a more dysbiotic and pathogenic microbial community in their saliva than healthy individuals. Therefore, the gradual transition in the entire salivary microbial community from healthy to diseased includes a gradual shift to dysbiosis. Free salivary pathogens might play an important role in the recolonization of bacteria as well as the prognosis and recurrence of periodontal diseases.

Identification of inflammation-related DNA methylation biomarkers in periodontitis patients based on weighted co-expression analysis.

Evidence from past research has shown that DNA methylation plays a key role in the pathogenesis of periodontitis, regulating gene expression levels and thereby affecting the occurrence of various diseases. Three sample sets of methylation data and gene expression data were downloaded from Gene Expression Omnibus (GEO) database. A diagnostic classifier is established based on gene expression data and CpG methylation data. Abnormal expression of immune-related pathways and methyltransferase-related genes in patients with periodontitis was detected. A total of 8,029 differentially expressed CpG (DMP) was annotated to the promoter region of 4,940 genes, of which 295 immune genes were significantly enriched. The CpG sites of 23 differentially co-expressed immune gene promoter regions were identified, and 13 CpG were generally hypermethylated in healthy group samples, while some were methylated in most patients. Five CpGs were screened as robust periodontitis biomarkers. The accuracy in the training data set, the two external verification data sets, and in the transcriptome was 95.5%, 80% and 78.3%, and 82.6%, respectively. This study provided new features for the diagnosis of periodontitis, and contributed to the personalized treatment of periodontitis.

C – reactive protein in saliva of non-smoking patients with periodontitis (a pilot study)

Introduction: C-reactive Protein (CRP) as an inflammatory biomarker can be easily determined in saliva, but the values of salivary CRP in periodontitis are not well-studied. The aim of this study was to analyze and determine the values of salivary CRP in non-smokers with periodontitis stage 3 or 4 before and after supragingival and subgingival full-mouth periodontal therapy.Methods: Standard periodontal parameters and saliva samples were collected in 12 non-smoking patients. Patients in the test group (n = 6) underwent supragingival and subgingival full-mouth periodontal therapy, and the control group (n = 6) received only supragingival full-mouth therapy. Both groups received the same oral hygiene instructions in addition to therapy. After 3 months, re-registration of periodontal parameters and re-sampling of saliva for analysis of salivary CRP were done for both groups.Results: Statistical analysis revealed large differences in the values of clinical periodontal parameters and CRP levels in the test group after therapy. Values of salivary CRP in the test and control groups were lower 3 months the therapy; however, the results were not statistically significant. The correlation of clinical periodontal parameters and salivary CRP varied in both groups.Conclusion: Our pilot study reveals decreased concentrations of salivary C-reactive protein in non-smoking patients following non-surgical periodontal therapy. Further studies are needed to prove the reliability of salivary CRP as a biomarker for periodontitis.

Saliva as a Source of Biomarkers for Periodontitis and Periimplantitis

Saliva has the potential to be used as a diagnostic and monitoring tool for various diseases if biomarkers of an adequate sensitivity and specificity could be identified. Several reviews and even meta-analyses have been performed in recent years, which have found some candidate biomarkers for periodontitis, like macrophage inflammatory protein-1 alpha, interleukin-1ß, interleukin-6, matrix metalloproteinase-8, or hemoglobin. However, none of those are currently in use to replace conventional periodontal diagnostics with a periodontal probe. For periimplantitis, to date, heterogeneity of different study protocols and implant types did not permit to discover clear biomarkers, which were able to distinguish between healthy and diseased implants. Few proinflammatory cytokines, similar to periodontitis, have been characterized as adjunct tools to clinical diagnosis. The additional determination of antimicrobial peptides, bone turnover markers, and bacteria could help to enhance sensitivity and specificity in a combined model for periodontitis and periimplantitis. Furthermore, proteomic approaches might be preferred over single biomarker determinations. A global consensus is also needed to harmonize salivary sampling methods as well as procedures of biomarker analysis to ensure future comparability.