Periodontal diseases affect about 11% of the general global population and about 75% of all adults.23 They are inflammatory conditions affecting both soft and hard structures supporting the teeth and are characterized by bleeding, swelling, increased pocket depth, and bone loss.24 Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans are considered the main causative pathogens.25
Periodontal diseases include gingivitis (i.e., a reversible stage of inflammation), initial stage periodontal disease (i.e., early bone loss with 3-5 mm pockets), followed by moderate periodontitis (i.e., bone loss with 5-7 mm pockets), and severe periodontal disease (i.e., with more than 7 mm bone loss). The clinical phase of gingival/periodontal problems is assessed visually, by physical examination, and radiographically.
The preclinical phase of periodontal diseases is detectable by using genetic, microbial, and protein biomarkers.25 Gingival crevicular fluid-based biomarkers indicate gingival and periodontal inflammation.8 However, it is invasive, expensive, time-consuming, requires training and needs laboratory processing.8 As compared to gingival crevicular fluid, whole saliva is more easily accessible and simple to collect.
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