Oral Fluid–Based Biomarkers of Alveolar Bone Loss in Periodontitis

Abstract

: Periodontal disease is a bacteria‐induced chronic inflammatory disease affecting the soft and hard supporting structures encompassing the teeth. When left untreated, the ultimate outcome is alveolar bone loss and exfoliation of the involved teeth. Traditional periodontal diagnostic methods include assessment of clinical parameters and radiographs. Though efficient, these conventional techniques are inherently limited in that only a historical perspective, not current appraisal, of disease status can be determined. Advances in the use of oral fluids as possible biological samples for objective measures of current disease state, treatment monitoring, and prognostic indicators have boosted saliva and other oral‐based fluids to the forefront of technology. Oral fluids contain locally and systemically derived mediators of periodontal disease, including microbial, host‐response, and bone‐specific resorptive markers. Although most biomarkers in oral fluids represent inflammatory mediators, several specific collagen degradation and bone turnover‐related molecules have emerged as possible measures of periodontal disease activity. Pyridinoline cross‐linked carboxyterminal telopeptide (ICTP), for example, has been highly correlated with clinical features of the disease and decreases in response to intervention therapies, and has been shown to possess predictive properties for possible future disease activity. One foreseeable benefit of an oral fluid–based periodontal diagnostic would be identification of highly susceptible individuals prior to overt disease. Timely detection and diagnosis of disease may significantly affect the clinical management of periodontal patients by offering earlier, less invasive, and more cost‐effective treatment therapies.

Human soluble receptor for advanced glycation end products and tumor necrosis factor-α as gingival crevicular fluid and serum markers of inflammation in chronic periodontitis and type 2 diabetes

“…Chronic periodontitis (CP) is an inflammatory disease of multi-factorial origin which causes the destruction of supporting tooth structures by releasing a broad array of inflammatory mediators (1). Activation of the inflammatory-immune system by periodontal pathogens leads to chronic inflammation, causing progressive destruction of the connective tissues and resorption of the alveolar bone; if left untreated, it finally leads to tooth loss (2,3).…”

Growth Factors and Connective Tissue Homeostasis in Periodontal Disease

“…Recently, gingival crevicular fluid (GCF) and saliva are in the middle of high-throughput techniques aimed to validate tests for the objective diagnosis of disease, monitoring, and prognostic indicators. Oral fluids contain locally and systemically derived mediators of periodontal disease, including pathogens, host-response, and bone-specific markers (Kinney et al, 2007). Most biomarkers assessed in oral fluids are inflammatory cytokines, but some collagen degradation products and bone turnover-related molecules have emerged as possible markers of periodontal disease activity, too.…”

“…Among those which are the potential candidates for oral fluid-based diagnostics of periodontal disease are included: alkaline phosphatase, MMP-8, MMP-9, MMP-13, osteocalcin, osteonectin, osteopontin, and pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (Arikan et al, 2008(Arikan et al, , 2011Buduneli et al, 2008;Kinney et al, 2007;Miller et al, 2006;Ozçaka et al, 2011) but the list is still open.…”

Salivary Biomarkers for Periodontal Diseases-A Review

“…MMP-13 may be useful for diagnosing, monitoring the course of periodontal disease and for tracking the efficacy of therapy. 28,29,33 Conclusion Saliva is said to be a "mirror of the body" because it is an indicator of health not just in the oral cavity but throughout the body. It is likely that the development of saliva based biomarkers will impact and expand the role of dentists.…”