Assessment of Serum Ferritin Levels and Periodontal Indices in Patients with Chronic Periodontitis Post/Pre Radiation Treatment of Head and Neck Cancer

Acute phase protein (APP) positivity is exhibited by ferritin in the presence of inflammation and chronic infections, such as periodontal disease. This study aims to investigate serum ferritin levels compared between post- and pre-radiation of periodontal disease with head and neck cancer PD+HNC. A total of 100 individuals in the present study were enrolled, comprising 50 patient’s periodontal disease (PD) with head and neck cancer who underwent radiotherapy post-six months (post-RT HNC) and 50 PD patients (pre-RT HNC). Probing pocket depth (PPD), clinical attachment level (CAL), gingival bleeding index (GBI), plaque index (PI), oral pH, and hyposalivation were noted. Serum ferritin levels were measured using an electrochemiluminescence immunoassay (eCLIA). A significantly higher percentage of ferritin levels was found in patients post-RT PD+HNC (301.90 ng/ml) contrasted to pre-RT PD+HNC (82.71 ng/ml) subjects. Serum ferritin levels were shown to be significantly positively correlated with CAL, PPD, PI, and GBI in subjects with chronic periodontitis. Receiver operating characteristic results of ferritin (area under the curve (AUC) =0.806 for post-RT PD+HNC, AUC=0.454 for pre-RT PD+HNC). It may be suggested that elevated serum ferritin levels in patients with post-RT PD+HNC have the potential to be evaluated as biomarkers for inflammation during periodontal tissue breakdown via radiation treatment.