Biomarker is an objective measure that has been evaluated and confirmed either as an indicator of physiologic health, a pathogenic process or a pharmacologic response to a therapeutic intervention. Biomarkers, whether produces by normal healthy individuals or by individuals affected by specific systemic diseases, are tell tale molecules that could be used to monitor health status, disease onset, treatment response and outcome.The biomarkers can help for the determination of present as well as future disease activity along with diagnosis and previous periodontal diseases.

1. BIOMARKERS IN
PERIODONTAL
DISEASES
By- Dr. Prathamesh Fulsundar

2. INTRODUCTION
• The clinical diagnostic criteria which is used
currently measures the disease severity rather than
disease activity.
• Biomarkers are the recent advances in the periodontal
diseases.
• The biomarkers can help for the determination of
present as well as future disease activity along with
diagnosis and previous periodontal diseases.
• Goal Of Periodontal Diagnostic Procedures Is To
Provide Useful Information To The Clinician
Regarding The Present Periodontal Disease, Type,
Location, And Severity Which Serves As A Basis
For Treatment Planning, And Provide Essential Data
During Periodontal Maintenance And Disease
Monitoring Phases Of Treatment.

5. NEED FOR BIOMARKERS
• A periodontal diagnostic tool provides pertinent information for
differntial diagnosis,localization of disease and severity of
infection.
• These diagnosis inturn serve as a basis for planning treatment
and provide a mean for assesing the effectiveness of
periodontal therapy
• Conventional disease diagnosis techniques lack the capacity to
identify high susceptible patients who are at risk for future
breakdown.
• Both automated periodontal probes and subtraction
pradiography techniques are most after seen in the research
setting and seldom in clinical practiceResearchers are
confronted then with the need for an innovative diagnostic test
that focuses on the early recognition of microbial challenge to
the host.
• Optimal innovative approach would correctly determine the
presence of the current disease activity predict the vulnerable sites for
periodontal interventions.this can be shown as in th.e figure below.

6. A NEW PARADIGM FOR PERODONTAL DIAGNOSIS WILL ULTIMATELY
AFFECT THE IMPROVED CLINICAL MANAGEMENT OF PERIODONTAL
PATIENTS

7. GCF AS A DIAGNOSTIC MARKER

8. ROLE OF ORAL FLUIDS AS BIOMARKERS IN
PERIODONTAL DISEASES
• Saliva plays many important roles in the mouth.
Saliva helps us breathe and swallow by
lubricating the oral tissues.
• Enzymes found in saliva begin the digestive
process. Saliva also helps protect the teeth from
cariogenic bacteria.
• At present, saliva is rapidly gaining popularity as
an important diagnostic tool, thereby offering the
possibility to detect diseases earlier than before.1
• Saliva is now being used to detect a growing
number of oral diseases including caries,
periodontal disease, and oral cancer, as well as
systemic disorders.2

9. • Point-of-care technologies offer the ability to help
facilitate chairside saliva testing.2
• Some tests are readily available on the market
and more are emerging. These exciting new
medical advances will allow dental hygienists to
expand their role in offering this valuable service
to patients.
• In addition to facilitating early detection of a
disease, salivary tests also offer an important
educational aid for oral hygiene counseling and
patient motivation.
•

10. DIAGNOSTIC TOOLS TO MEASURE PERIODONTAL
DISEASES

11. SALIVA-A DIAGNOSTIC BIOMARKER IN
PERIODONTAL DISEASES

12. MAJOR BIOMARKERS

13. USE OF GENOMICS IN PERIODONTAL
DIAGNOSIS – A CRITICAL ANALYSIS
• Single-nucleotide polymorphism
Several researchers have focused on genetic single-nucleotide
polymorphisms in the study of periodontitis. There is a genetic
susceptibility test currently available for severe chronic periodontitis
(Interleukin Genetics, Waltham, MA, USA). This system works by
the detection of two types of IL-1 genetic alleles, IL-1α +4845 and
IL-1β +3954 [137]. Individuals identified as “genotype positive,” or
found to have both of these alleles, are more likely to have the
phenotype of overexpression of this gene .

15. • NUCLEIC ACID PROBES
In recent years, DNA probes have been developed to identify nucleotide
sequences that are specific for individual bacterial species, believed to be of
diagnostic significance. DNA and RNA probes are available .
• Critical analysis
In the future, mini molecular laboratories will be available for chair-side
DNA probe testing in an hour or less (Periodontal Microbial Identification
Test, Saigene Corp, Bothell, WA, USA). However, the advice of a
microbiologist might still sometimes be necessary to avoid problems that
may occur in the diagnostic process.

16. INFRARED SPECTROSCOPY
• Compared to analyzing one or more particular biomarkers in the tissue or body
fluid, infrared (IR) spectroscopy analyzes complex biologic systems by capturing
the entire IR spectrum that represents the sum of the contributions of the
biomolecules present, such as proteins, lipids, sugars, and nucleic acids. The IR
spectrum of GCF is a rich source of information regarding the oral cavity and
associated inflammation.
• Critical analysis
• IR spectroscopy can distinguish between the characteristics of diverse molecules by
probing vibrations of chemical bonds and can use these molecular and submolecular
profiles to define and differentiate between diseased and healthy tissues. IR analysis
of GCF, unlike traditional biochemical analyses, measures the total contents of GCF
and may prove to be a more powerful diagnostic and prognostic tool for periodontal
diseases.

17. FUTURE DIRECTONS AND SUMMARY
1. There is a plethora of possibilities for the future use of oral fluids in biotechnology and
health care applications, especially in the field of diagnostics.
2. From physical measurements by periodontal probing to sophisticated genetic susceptibility
analysis and molecular arrays for the detection of biomarkers on the different stages of the
disease, substantial improvements have been made in the understanding of the mediators
implicated on the initiation, pathogenesis, and progression of periodontitis.
3. Through this a new therapeutics have been designed linking therapeutic and diagnostic
approaches together, especially in the area of host modulatory drugs for periodontal disease
treatment.
4. The future is bright for the use of rapid, easy-to-use diagnostics that will provide
an enhanced patient assessment that can guide and transform customized therapies
for dental patients, leading to more individualized, targeted treatments for oral
treatmennt.