Gingival Crevicular Fluid Volume and Protein Concentration: A Biomarker Tool for Predicting Periodontal Diseases Progression and Severity

Periodontitis represents a significant public health challenge due to its complex pathogenesis and prevalence. This inflammatory disorder, driven by an interplay between microbial agents and the host immune response, emphasizes the critical need for early and accurate diagnostics. This study aims to measure the volume of GCF using Periotron® and potential biomarkers (NETs and IL-23) to predict periodontal disease severity and progression. In this cross-sectional study, 90 subjects (30 controls, 30 with Stage 1 periodontitis, and 30 with Stage 3 periodontitis) were involved at the Periodontics Department of the Dental College Teaching Hospital at Baghdad University. Samples were collected from November 2023 to May 2024. Participants were assessed for periodontal parameters, including Clinical Attachment Loss (CAL), Bleeding on Probing (BOP), and Probing Depth (PD). Gingival Crevicular Fluid (GCF) samples were collected and analyzed to measure the levels of NETs and IL-23 by enzyme-linked immunosorbent assay (ELISA). The GCF volumes were quantified using the Periotron® 8010 device. A significant increase significantly in levels of NETs and IL-23 were found in stage 3 periodontitis (73.90 ± 6.58), (5.018 ± 1.081) compared to those in stage 1 and healthy controls (43.17 ± 4.47), (3.083 ± 0.569), (19.43 ± 4.63), (1.431 ± 0.586). The increased biomarker levels correlated significantly with higher GCF volumes (P <0.05). The findings suggest that NETs and IL-23 are significantly elevated in severe cases of periodontitis and may serve as reliable biomarkers for assessing disease progression. Their quantification could support the development of tailored treatment strategies, potentially improving patient outcomes.