Critical analysis of biomarkers in the current periodontal practice

Abstract

Periodontal disease is a chronic microbial infection that triggers inflammation-mediated loss of the periodontal ligament and alveolar bone that supports the teeth. Because of the increasing prevalence and associated comorbidities, there is a need for the development of new diagnostic tests that can detect the presence of active disease, predict future disease progression, and evaluate the response to periodontal therapy, thereby improving the clinical management of periodontal patients. The diagnosis of active phases of periodontal disease and the identification of patients at risk for active disease represent challenges for clinical investigators and practitioners. Advances in diagnostic research are moving toward methods whereby the periodontal risk can be identified and quantified by objective measures using biomarkers. Patients with periodontitis may have elevated circulating levels of specific inflammatory markers that can be correlated to the severity of the disease. Advances in the use of oral fluids as possible biological samples for objective measures of the current disease state, treatment monitoring, and prognostic indicators have boosted saliva- and other oral-based fluids to the forefront of technology. Gingival crevicular fluid (GCF) is an inflammatory exudate that can be collected at the gingival margin or within the gingival crevice. This article highlights recent advances in the use of biomarker-based disease diagnostics that focus on the identification of active periodontal disease from plaque biofilms, GCF, and saliva.

Saliva as a future potential predictor for various periodontal diseases

“…Several important components of saliva that can be used as indicators of periodontal disease are microbial factors, host derived enzymes, inflammatory mediators and host response modifiers, and products of tissue breakdown. [1][2][3][4][5][6][7][8] Recently, saliva has been studied as an important biological marker for introducing new diagnostic tests that can contribute to making the accurate diagnosis to explain the pathogenesis of a disease. There was many biomarkers of periodontal diseases have found in saliva.…”

“…There was many biomarkers of periodontal diseases have found in saliva. [2][3][4][5] Over the last two decades, researchers in the oral health have been trying to develop a diagnostic tool to use saliva to monitor various periodontal diseases. 6,8 The development of salivary diagnostic technology currently leads the development of diagnostic tools that simply, quickly and accurately to facilitate the dentists in making clinical decisions and predict the outcome of treatment in the oral cavity, including the diseases related to the general health.…”

“…15 Salivary indicators such as intracellular enzymes are increasingly released from the damaged cells of periodontal tissues into the gingival crevicular fl uid (GCF) and saliva. 2 The activities several enzymes of periodontal disease such as creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamil transferase (GGT), alkaline phosphatase (ALP) and acid phosphatase (ACP) enzymes were signifi cantly increased in the saliva of patients with periodontal disease when compared to healthy subjects.…”

Biomarkers: A Critical Update

“…However, the advice of a microbiologist might still sometimes be necessary to avoid problems that may occur in the diagnostic process (11).…”

Trends in Laboratory Diagnostic Methods in Periodontology

“…Based on the above-mentioned analyses, it is possible to determine the current level of periodontal damage, and the future course of the disease can be anticipated. Although analysis of gingival crevicular fluid helps provide an explanation of the inflammatory response in periodontitis, multiple collection of samples with the assistance of traditional filter papers is currently considered to be impractical in clinical practice (22,27). In recent years gingival crevicular fluid been revived as an excellent indicator of the current local state of the periodontal tissue during the testing of local application of biodegradable nanoparticles of drugs (50).…”