Emerging Biomarkers in Periodontal Disease: Diagnostic and Prognostic Implications

Periodontal disease represents a significant global health burden, affecting approximately 50% of the adult population worldwide. Current diagnostic methods primarily rely on clinical parameters and radiographic assessment, which have inherent limitations in detecting early disease activity and predicting future progression. This narrative review aims to synthesize current evidence on emerging biomarkers in periodontal disease and evaluate their diagnostic and prognostic implications. We conducted a comprehensive literature search of PubMed and Scopus databases, focusing on studies published within the last decade that investigated novel biomarkers for periodontal disease. The review identifies several categories of promising biomarkers, including host-derived inflammatory mediators, tissue breakdown products, microbial signatures, genetic markers, and salivary biomarkers. Additionally, we explore the potential of omics-based approaches, including proteomics, metabolomics, and transcriptomics, in identifying novel biomarker panels. The evidence suggests that these emerging biomarkers demonstrate considerable promise in enhancing early detection, differentiating between disease phenotypes, monitoring treatment response, and predicting disease progression. However, challenges remain regarding standardization, validation, and clinical implementation. Multi-marker approaches appear to offer superior diagnostic and prognostic accuracy compared to single biomarkers. The integration of novel biomarkers with traditional clinical assessment may pave the way for personalized periodontal care, enabling targeted interventions based on individual risk profiles and disease activity