Abstract:
Periodontal disease is a chronic inflammatory condition affecting the supporting
structures of teeth, which if left untreated, worsens gradually and can have serious
consequences on the periodontium. There are several risk factors for periodontitis but
smoking or tobacco use, and poor oral hygiene are the leading cause. Early diagnosis of
periodontal disease is essential for successful treatment outcomes. Traditional diagnostic
methods rely on clinical assessment and radiographic imaging, but these methods have
limitations, particularly in identifying early-stage disease. According to W.H.O, it was
reported that 18% population of Pakistan has some form of periodontal problems and out
of these 31% has periodontitis. The purpose of this study is to evaluate salivary levels of
MMP-8, IL-1β and IL-6 in healthy and periodontitis patients and to assess the association
between these biomarkers’ levels and clinical parameters. This was a case control study
which was conducted at the Dental OPD of Bahria University Medical Health Sciences
Karachi over a period of six months. 76 participants were included in the study after
randomization, 38 subjects for control group and 38 subjects for case group. In control
group a healthy periodontium is defined as the absence of either gingivitis or periodontitis
history (BOP < 10%, PPD ≤ 3 mm, no proximal clinical attachment loss (CAL), and no
recession).In case group periodontitis patient defined as a patient who had at least two
nonadjacent teeth with interdental clinical attachment loss (CAL) ≥ 2 mm, probing pocket
depth (PPD) > 3 mm, and radiographic evidence of bone loss. Periodontal examination
and saliva sampling were performed in all patients. Saliva sample was taken for
measuring different parameters like Plaque Index (PI), Calculus Index (CI), Periodontal
Probing Depth (PPD), Clinical Attachment Loss (CAL) and Bleeding on Probing (BOP),
after taking ethical approval from Bahria University Health Sciences Karachi
(BUHSCK). Levels of salivary cytokines including MMP-8, IL-1β and IL-6 were
evaluated by sandwich ELISA test kit. For Statistical analysis: Data analysis was done by
using IBM SPSS Statistics v27.Mean and standard deviation were calculated for
quantitative variables whereas frequency and percentage were reported for qualitative
VIII
variables. Mean comparison of IL-1β, IL-6 and MMP-8 according to study groups were
done by using independent t test. P- value less than 0.05 were considered as significant.
Results: IL-1β, MMP-8 and IL-6 levels were significantly higher in periodontitis patients.
We found significant association for gender(p=0.022), age groups(p=0.000), any co morbid (p=0.012), plaque (p=0.001), calculus(p=0.002), bleeding on probing (p=0.001)
and clinical attachment loss (p=0.001) whereas no significant association were found with
dietary habits, and medication use (p=0.108). Concentration of these proteins in saliva
showed significant association with plaque index, calculus index, periodontal pocket
depth and clinical attachment loss and it reflect the clinical status of diseased
periodontium. In conclusion, salivary biomarkers have emerged as a promising tool for
the early diagnosis and monitoring of periodontal disease by providing valuable
information about disease status.
