Salivary and Gingival Crevicular Fluid Biomarkers in the Early Diagnosis of Periodontitis: A Narrative Review

Abstract
Background: Periodontitis is a chronic inflammatory condition characterized by progressive destruction of periodontal supporting tissues. Conventional diagnostic tools such as probing depth and radiographs primarily reflect historical tissue damage and do not adequately indicate current disease activity. Biomarkers present in saliva and gingival crevicular fluid (GCF) have emerged as potential tools for early detection and monitoring of periodontal disease.
Objective: This review aims to critically evaluate host derived, microbial, and genetic biomarkers in saliva and GCF that may facilitate early diagnosis and risk assessment of periodontitis.
Methods: A structured literature review was conducted using electronic databases including PubMed and Scopus. Articles published between 2005 and 2025 focusing on salivary and GCF biomarkers for periodontal diagnosis were analysed. Clinical trials, cohort studies, and systematic reviews were considered.
Results: Among the various biomarkers studied, inflammatory mediators such as IL-1β, IL-6, TNF-α, and matrix metalloproteinases particularly active MMP-8 demonstrate significant diagnostic value. Biomarkers associated with bone metabolism (RANKL/OPG ratio) and specific periodontal pathogens also show promising correlations with disease activity.
Conclusion: Biomarker based diagnostics represent a paradigm shift toward predictive and personalized periodontal care. Although promising, further standardization and longitudinal validation are necessary before routine implementation in clinical practice.