Comparative Evaluation of Salivary Chemerin and Matrix Metalloproteinase-9 Levels in Healthy Individuals, Patients With Periodontitis, and Patients With Oral Squamous Cell Carcinoma: A Cross-Sectional Study

Background: Periodontitis and oral squamous cell carcinoma (OSCC) are chronic inflammatory conditions linked to systemic health and share biological pathways involving immune dysregulation, oxidative stress, and tissue destruction. Aim: The aim of the study is to evaluate and compare salivary chemerin and matrix metalloproteinase-9 (MMP-9) levels among healthy individuals, periodontitis patients, and OSCC patients, and to assess their potential diagnostic utility. Materials and methods: A cross-sectional study was conducted on 90 participants divided into three groups (n = 30 each): healthy controls, periodontitis patients, and OSCC patients. Unstimulated saliva samples were obtained and analyzed for chemerin and MMP-9 using enzyme-linked immunosorbent assay (ELISA). Periodontal parameters, including oral hygiene index-simplified (OHI-S), Russell’s index, probing pocket depth (PPD), and clinical attachment loss (CAL), were recorded. Analysis of variance (ANOVA), Tukey’s post hoc test, and Pearson correlation were used for statistical analysis. Results: Salivary chemerin and MMP-9 levels were significantly elevated in both periodontitis and OSCC patients compared to healthy individuals, with the highest levels observed in the OSCC group. MMP-9 demonstrated a stronger association with periodontal tissue destruction. Analysis revealed a direct association between chemerin and MMP-9 concentrations. Conclusion: Salivary chemerin and MMP-9 levels were significantly higher in periodontitis and OSCC patients than in healthy individuals, with the highest levels observed in the OSCC group. Elevated biomarker levels were associated with worsening periodontal parameters, indicating their role in inflammation, tissue destruction, and tumor progression. These findings suggest a possible inflammatory link between periodontitis and OSCC and support the potential of salivary chemerin and MMP-9 as non-invasive biomarkers for disease diagnosis and monitoring.