Update on the Role of Cytokines as Oral Biomarkers in the Diagnosis of Periodontitis.

Periodontitis is one of the world's most common chronic human diseases and has a significant impact on oral health. Recent evidence has revealed a link between periodontitis and certain severe systemic conditions. Moreover, periodontal patients remain so for life, even following successful therapy, requiring ongoing supportive care to prevent the disease's recurrence. The first challenge in treating the condition is ensuring a timely and accurate diagnosis since the loss of periodontal bone and soft tissue is progressive and largely irreversible. Although current clinical and radiographic parameters are the best available for identifying and monitoring the disease, the scientific community has a particular interest in finding quantifiable biomarkers in oral fluids that can improve early detection rates of periodontitis and evaluations of its severity. It is widely accepted that periodontitis is associated with polymicrobial dysbiosis and a chronic inflammatory immune response in the host. This response causes the generation of mediators like cytokines. Higher concentrations of cytokines are involved in inflammation and disease progression, acting as a network of biological redundancy. Most of the cytokines investigated concerning the periodontitis pathogenesis are proinflammatory. Of all of them, interleukin (IL) 1beta has been studied the most, followed by tumor necrosis factor (TNF) alpha and IL6. In contrast, only a few papers have evaluated antiinflammatory cytokines, with the most researched being IL4 and IL10. Several systemic reviews have concluded that the specific cytokines present in patients with periodontitis have a distinctive profile, which may indicate their possible discriminatory potential. In this chapter, the focus is on analyzing studies that investigate the accuracy of diagnoses of periodontitis based on the cytokines present in gingival crevicular fluid and saliva. The findings of our research group are also described.