Salivary Biomarkers of Periodontal Disease and Therapeutic Outcome

We previously reported the use of salivary biomarkers for the assessment of periodontal disease that targeted biological aspects of the disease. The validity of these biomarkers as accurate diagnostic aids remains to be defined. Objectives: To validate the utility of salivary biomarkers in the assessment of periodontal disease and determine if salivary biomarkers of periodontal disease reflect response to mechanical periodontal therapy. Methods: A 6-month longitudinal study enrolled 26 individuals who had generalized moderate to severe periodontal disease. Subjects received standard periodontal examinations and were randomly assigned to receive oral hygiene instructions (OHI) only (n=13) or periodontal debridement (PD, n=13) at baseline, week 16, and week 28. At each visit, periodontal measures were recorded and unstimulated whole saliva (UWS) was collected. UWS were analyzed for IL-1β and MMP-8 using Luminex bead-multiplexed or ELISA procedures, respectively. Results: The age, race, gender, baseline clinical parameters of periodontal disease, and baseline salivary analyte levels were not significantly different between the groups. Mechanical PD therapy resulted in improved periodontal health and significantly decreased salivary levels of IL-1β and MMP-8 at week 16 and 28 compared with baseline (p<0.05). UWS IL-1β levels decreased in the PD group from 93.6 + 71.04 pg/ml to 53.6 + 63.1 pg/ml by week 16 and maintained this level at week 28. Similarly, UWS MMP-8 levels decreased in the PD group from 294.2 + 178.1 ng/ml to 177.4 + 194.1 ng/ml by week 16 and remained lower at week 28. In contrast, salivary analyte levels in the OHI group did not improve and reflected a state of persistent periodontal inflammation. Conclusion: These data suggest that IL-1β and MMP-8 are accurate salivary biomarkers of periodontal disease, and their levels reflect response to therapy. Study supported by NIH grants U01 DE15017, P20 RR020160 and M01 RR02602.