Prognostic utility of oral neutrophil counts in high-risk periodontitis: A retrospective study.

BACKGROUND

Oral polymorphonuclear neutrophil (oPMN) levels are potential biomarkers for differentiating between stages and grades of periodontitis. We compared the diagnostic utility of oPMN levels with bleeding on probing percentage (BOP%) and microbial load in high-risk patients with periodontitis.

METHODS

Sixty-two subjects were divided into four categories based on periodontitis stage and grade: stage II periodontitis (S2P, n = 19), stage III periodontitis (S3P, n = 43), grade B periodontitis (GBP, n = 34), and grade C periodontitis (GCP, n = 28). Clinical parameters included probing depth (PD), BOP%, and clinical attachment loss (CAL). Associations between oPMN levels and BOP% were compared to periodontitis stage and grade, and the presence of the periodontal pathogens Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), Aggregatibacter actinomycetemcomitans, and Prevotella intermedia (Pi) in the gingivocrevicular fluid (GCF).

RESULTS

Both oPMN levels and BOP% were associated with increasing stage and grade of periodontitis; however, better sensitivity, specificity, and predictive values for differentiating between GBP versus GCP were observed with oPMN. Significant positive associations were found between oPMN level and the detection of Pg and Pi.

CONCLUSIONS

OPMN level can be used to differentiate between grade B and C periodontitis. Likewise, the presence of periodontal pathogens Pg and Pi correlated with the oPMN level. Given these findings, oPMN level may be useful as a multipurpose clinical biomarker in terms of diagnosing periodontitis and determining the risk of disease progression.

PLAIN LANGUAGE SUMMARY: Periodontitis is a serious gum disease that can lead to tooth loss and is linked to other health issues. Currently, bleeding of the gums after probing is one method used to assess the disease activity, but this method is not always accurate. In this study, we investigated whether counting a type of immune cell called oral neutrophil found in saliva could provide a better way to detect and measure the severity of periodontitis. We examined 62 patients with different stages and grades of the disease. We found that the number of oral neutrophils was a better tool for identifying more severe cases and those at a higher risk for future breakdown than gum bleeding. We also found that higher levels of neutrophils were linked to the presence of harmful bacteria that cause periodontitis. These findings suggest that measuring oral neutrophils could be a more reliable way to diagnose and monitor periodontitis, helping dentists identify severe cases earlier and treat patients more effectively. This method could improve how we understand and manage gum disease, leading to better patient-centered outcomes.