Study On Salivary Cytokine Markers Combined With Clinical Parameters To Evaluate The Effect Of Periodontal Initial Therapy

Objective:Through the analysis of salivary cytokine markers and clinical parameters related to the prognosis of patients with periodontitis,and then to explore the efficacy of their combined application in predicting the effect of basic treatment of patients with periodontitis,to provide basis and ideas for personalized diagnosis and treatment of patients with periodontitis Methods:Thirty patients with stage Ⅱ-Ⅳ chronic periodontitis attending the outpatient clinic of the Department of Oral Medicine of the First Hospital of Shanxi Medical University from October 2021 to October 2022 were selected.Non-irritating saliva and whole-mouth clinical parameters were collected from the subjects at baseline from 9:00am to 11:00 am.The probing depth(PD),clinical attachment loss(CAL),tooth surface position(inter-dental/not inter-dental),site position(non-molar sites,molar sites with root bifurcation lesions and molar sites without root bifurcation lesions),number of teeth lost,and maximum clinical attachment loss/age were recorded for the six remaining tooth sites(proximal buccal,proximal mesial,proximal lingual,distal buccal,distal mesial,and distal lingual).The levels of cytokines interleukin-1β(IL-1β),interleukin-6(IL-6),matrix metalloproteinase-8(MMP-8)and tumour necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay(ELISA)in saliva samples.The levels of different salivary cytokines with clinical parameters were used as independent variables.After three months of periodontal initial therapy,the presence or absence of periodontal pocket closure and further attachment loss in the remaining teeth was recorded as the dependent variable.Correlations were explored by generalised estimating equations and modelled to predict outcomes.Results:1.In the one-way model,the correlation between PD,CAL and salivary IL-1β and IL-6 levels at baseline and periodontal pocket closure at 3 months was statistically significant(P<0.05),while the other parameters were not statistically significant(P>0.05);the correlation between CAL and salivary IL-6 and TNF-α levels at baseline and the occurrence of further attachment loss at periodontal sites at 3 months was statistically significant(P<0.05),while the other parameters were not statistically significant(P>0.05).2.A multivariate model combining baseline clinical parameters and salivary cytokine parameters was more effective in predicting periodontal pocket closure after mechanical treatment(AUC value =0.862)compared to PD(AUC =0.732),CAL(AUC= 0.666)and salivary IL-1β(AUC = 0.674)and IL-6(AUC = 0.682)concentration levels univariately;compared to CAL(AUC=0.755)and salivary IL-6(AUC=0.744)and TNF-α(AUC=0.687)at baseline,the multivariate model was more effective in predicting the presence or absence of further clinical attachment loss than the univariate model(AUC value=0.871).Conclusion:1.In patients with stage Ⅱ-Ⅳ periodontitis,the baseline clinical parameters PD,CAL and salivary biomarkers IL-1β,IL-6 and TNF-α are associated with the outcome of periodontal initial therapy.2.The combination of baseline salivary cytokine markers and clinical parameters is more predictive of the outcome of periodontal initial therapy than alone.