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Eleni Litsou
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REVIEW ARTICLE

Salivary and inflammatory biomarkers in periodontitis: Current evidence and clinical applications

Eleni Litsou*
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1 Department of Otorhinolaryngology (ENT), University Hospital of Ioannina, Ioannina, Epirus, Greece
EJMO, 026130148 https://doi.org/10.36922/EJMO026130148
Received: 27 March 2026 | Revised: 25 May 2026 | Accepted: 25 May 2026 | Published online: 16 June 2026
(This article belongs to the Special Issue Biomarkers related to Oral diseases and periodontitis evolution)
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Periodontitis is a chronic inflammatory disease that leads to progressive destruction of the tooth-supporting tissues, while conventional clinical parameters mainly reflect past tissue damage and provide limited information on current disease activity. This review aims to critically summarize current evidence on salivary and inflammatory biomarkers associated with the onset, progression, and monitoring of periodontitis, with particular emphasis on their clinical applicability and current limitations in periodontal practice. A narrative review of the literature was conducted using PubMed, Scopus, and Web of Science databases. Priority was given to systematic reviews, meta-analyses, longitudinal clinical studies, and clinically relevant human studies published in English that addressed salivary inflammatory biomarkers in relation to periodontal disease activity, diagnosis, progression, and treatment monitoring. Evidence indicates that salivary cytokines, chemokines, matrix metalloproteinases, acute-phase proteins, and oxidative stress markers are associated with periodontal inflammation and tissue destruction. Among these, IL-1β, IL-6, TNF-α, and MMP-8 show the strongest associations with disease activity and treatment response. Although salivary biomarkers demonstrate strong biological associations with periodontal inflammation, heterogeneity among studies and lack of standardized diagnostic thresholds currently limit their routine chairside implementation. Further well-designed longitudinal studies are required to facilitate clinical translation.

Keywords
Periodontitis
Saliva
Inflammatory biomarkers
Cytokines
Matrix metalloproteinases
Funding
None.
Conflict of interest
The author declares that she has no competing interests.
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