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Various components of saliva have been studied as biomarkers for periodontitis screening in the recent past. Periodontitis is an infectious illness of the periodontium in which a series of immune-inflammatory processes cause connective tissue and alveolar bone to deteriorate. Interleukins, prostaglandins, and C-Reactive Protein (CRP) are pro-inflammatory mediators that play an important part in the pathophysiology. Salivary metabolites in gingival tissue have been shown to have a role in endothelial damage and decreased vasodilation mediated by Endothelin (ET-1) and Nitric Oxide (NO), since ET-1 dysfunction limits NO synthase. Oral dysbiosis development is also connected to substances such as antioxidants and vitamin C, which entail complicated signaling mechanisms between the immune system and bone. Various cells and biological substances are involved, including osteoblasts, receptor activator of nuclear factor kappa B ligand, osteoprotegerin, osteoclasts, bone morphogenetic proteins, organic skeletal matrix resorption products, and inorganic skeletal matrix indicators. Osteoclasts have been shown to break down various bone components during periodontal disease, culminating in the destruction of type I collagen by enzymes such as Matrix Metalloproteinases (MMPs). Thus, cross-linked telopeptides, such as C-terminal type I collagen telopeptide (β-CTX), enter the circulation as stable pieces. Periodontal disease management methods include regenerative treatments employing bone transplants, stem cells for bone remodeling/repairing, and nanotechnology-based approaches.
