Diagnostic Accuracy of Salivary Periodontal Biomarkers Is Reduced in Patients With Crohn's Disease

Abstract

​​​​​​​<span><b>Objectives</b>: Patients with Crohn's disease (CD) are at increased risk of developing periodontal disease and may benefit from salivary biomarker–based monitoring for early detection and management. Given the previously reported reduced specificity of the salivary aMMP‐8 test in CD, this study aimed to evaluate alternative salivary biomarkers for periodontal disease. </span><p><br></p><p><b>Materials and methods</b>: Stimulated saliva samples were collected from 35 patients with CD and 35 systemically healthy, matched controls, followed by a comprehensive periodontal examination. Salivary concentrations of total MMP‐8 (tMMP‐8), MMP‐9, and PMN elastase were quantified using ELISA. </p><p><b>Results</b>: In the control group, periodontal status significantly influenced the levels of all studied biomarkers, with significant differences observed in PMN elastase (<i>p</i> = 0.012), MMP‐9 (<i>p</i> = 0.003), and tMMP‐8 (<i>p</i> < 0.001). In contrast, within the CD group, only MMP‐9 levels showed significant variation across periodontal categories (<i>p</i> = 0.011). Intergroup comparisons revealed that among periodontally healthy individuals, those with CD had significantly higher salivary PMN elastase (<i>p</i> = 0.039) and MMP‐9 (<i>p</i> = 0.005) concentrations than controls. Furthermore, CD patients with gingivitis exhibited significantly higher tMMP‐8 levels (<i>p</i> = 0.035$) compared to the control group. However, no significant differences were observed between the CD and control groups among patients with periodontitis for any of the biomarkers (<i>p</i> ≥ 0.246). </p><p><b>Conclusions</b>: The diagnostic accuracy of salivary tMMP‐8 and PMN elastase was reduced in CD patients, likely reflecting altered neutrophil degranulation dynamics. Salivary MMP‐9 may serve as a promising biomarker linking oral and intestinal inflammatory activity. </p>