Evaluation of Salivary Biomarkers of Periodontal Disease Based on Smoking Status: A Systematic Review

Abstract

Saliva is a useful biomarker for diagnosing oral health conditions, including periodontal disease (PD). Smoking is a risk factor for PD. The aim of this systematic review was to summarize the salivary biomarkers associated with PD based on smoking status. A comprehensive search of the MEDLINE (via PubMed), EMBASE, Cochrane, SCOPUS, and Web of Sciences databases was conducted up to 1 January 2021 using key terms relevant to the topic of our research and Cochrane methodology and improved with searching a gray literature resource. The methodological quality of all included studies was assessed with the revised Quality Assessment of Diagnostic Accuracy Studies-2. Seven studies were included. Smokers had increased levels of malondialdehyde, sialic acid, salivary cortisol, salivary interleukin 1β, albumin, tissue inhibitor of matrix metalloproteinase (TIMP), and the pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), as well as decreased levels of superoxide dismutase, activity of lactate dehydrogenase, activity of enzyme activity of β-glucuronidase, uric acid, matrix metalloproteinase-8 (MMP-8)/TIMP-1 ratio, and combinations of MMP-8 and ICTP. However, mixed results were observed some studies in detecting glutathione peroxidase, MMP-8, and MMP-14. The results were interpreted with caution because of limitations in the number of included studies and the study design. Some salivary biomarkers are potentially useful in combination or alone for diagnosing PD. Methodological and systematic studies are needed to develop more effective biomarkers.

Matrix Metalloproteinases (MMPs) in Periodontium: Is It a Boon or a Bane?

“…Increased MMP expression has been linked not only to periodontal disease but also to systemic conditions. For example, MMP-8 levels were higher among periodontitis smokers than non-smokers [63]. MMPs are also implicated in gestational health.…”

Implication of serum and salivary albumin tests in the recent oral health related epidemiological studies: A narrative review

“…In a multicentre trial of 11,160 patients under general anaesthesia, perioperative oral management significantly improved serum albumin levels ( Yamada et al, 2021 ). A meta-analysis of salivary markers of periodontal disease found that smokers had higher salivary albumin levels ( Noh et al, 2022 ). In liver disorders where liver proteins like albumin decrease, low serum albumin levels have been linked to periapical periodontitis ( Grønkjær et al, 2016 ).…”

The oral microbiome and oral and upper gastrointestinal diseases

“…While gingivitis is a reversible condition, if left untreated, it may progress to periodontitis. Periodontitis is a more advanced stage of periodontal disease characterized not only by gingival inflammation but also by connective tissue attachment loss and bone loss, which may lead to tooth mobility and ultimately tooth loss [ 51 , 52 ]. Periodontitis manifests as gum redness, swelling, bleeding, and halitosis, accompanied by tooth mobility and potential tooth loss.…”