Alavi Seyed Ebrahim, Sharma Lavanya A, Sharma Ajay, Ebrahimi Shahmabadi Hasan
School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan 7717933777, Iran.
Mol Diagn Ther. 2025 Jul 18. doi: 10.1007/s40291-025-00799-1.
This review explores the transformative potential of salivary biomarkers in revolutionizing periodontal disease diagnostics and management through a non-invasive real-time analysis. A comprehensive literature search was performed using databases such as PubMed, Scopus, and Google Scholar, from inception to March 2025 employing keywords such as "salivary biomarkers," "periodontal disease," "biosensor," "precision dentistry," and "pro-inflammatory cytokines." Saliva, rich in inflammatory cytokines (e.g., interleukin-1β, interleukin-6, tumor necrosis factor-α), enzymatic markers (e.g., matrix metalloproteinase-8, matrix metalloproteinase-9), microbial DNA, oxidative stress indicators, and emerging biomarkers such as exosomes and microRNAs, offers a dynamic medium for early disease detection, risk stratification, and therapeutic monitoring. Technological advancements, including biosensors, lab-on-a-chip systems, and artificial intelligence-driven analytics, enable precise point-of-care applications that align with precision dentistry paradigms. These innovations facilitate personalized interventions by identifying subclinical inflammation, tracking disease progression, and tailoring treatments to individual molecular profiles. However, challenges such as biomarker variability, standardization of collection protocols, cost, and regulatory hurdles impede clinical translation. Future directions emphasize interdisciplinary collaboration, expanded biomarker panels, and rigorous clinical trials to validate diagnostic accuracy and scalability. By bridging gaps between laboratory research and clinical practice, salivary diagnostics promise to shift periodontal disease management from reactive to proactive care, enhancing patient outcomes and reducing systemic disease risks. This review underscores saliva's pivotal role in advancing oral health diagnostics while advocating for optimized methodologies to realize its full potential in precision dentistry.
本综述探讨了唾液生物标志物通过非侵入性实时分析在彻底改变牙周疾病诊断和管理方面的变革潜力。使用PubMed、Scopus和谷歌学术等数据库进行了全面的文献检索，检索时间从数据库创建至2025年3月，使用的关键词包括“唾液生物标志物”、“牙周疾病”、“生物传感器”、“精准牙科”和“促炎细胞因子”。唾液富含炎性细胞因子（如白细胞介素-1β、白细胞介素-6、肿瘤坏死因子-α）、酶标志物（如基质金属蛋白酶-8、基质金属蛋白酶-9）、微生物DNA、氧化应激指标以及外泌体和微小RNA等新兴生物标志物，为疾病早期检测、风险分层和治疗监测提供了一个动态媒介。包括生物传感器、芯片实验室系统和人工智能驱动分析在内的技术进步，实现了与精准牙科范式相一致的精确即时护理应用。这些创新通过识别亚临床炎症、跟踪疾病进展以及根据个体分子特征定制治疗方案，促进了个性化干预。然而，生物标志物变异性、采集方案标准化、成本和监管障碍等挑战阻碍了临床转化。未来的方向强调跨学科合作、扩大生物标志物组合以及进行严格的临床试验以验证诊断准确性和可扩展性。通过弥合实验室研究与临床实践之间的差距，唾液诊断有望将牙周疾病管理从被动治疗转变为主动护理，改善患者预后并降低全身疾病风险。本综述强调了唾液在推进口腔健康诊断方面的关键作用，同时倡导采用优化方法以充分发挥其在精准牙科中的潜力。
