Electrochemical Analysis of Whole Human Saliva for Periodontitis and Glycemic Status

Background: Periodontitis is a chronic inflammation of the periodontium caused by persistent bacterial infection, leading to the destruction of supporting tooth structures. It affects approximately 40% of the US population. Current diagnostic parameters, including bleeding on probing, clinical attachment levels, plaque index, gingival index, and bone loss, primarily indicate a history of disease. However, these markers become measurable only after significant tissue damage, making them poor prognosticators of disease progression or severity. Since periodontitis often progresses asymptomatically, many patients delay seeking care until the destruction is irreversible, and the ability to reconstruct the periodontium becomes limited. Early diagnosis is, therefore, critical for effective preventive intervention. Objective: This pilot study outlines implementing an electrochemical biosensor for the point-of-care (POC) assessment of periodontitis and related comorbidities. The project focuses on utilizing non-stimulated whole human saliva (WHS) as a non-invasive medium to monitor biomarkers associated with inflammation, soft tissue, and bone destruction, critical in periodontal disease progression. These biomarkers span microorganisms, enzymes, proteins, metal ions, and microRNA, ensuring a comprehensive approach to disease assessment. Material and Methods: The study uses WHS sample collection from 41 subjects, including controls and patients with varying stages of chronic periodontitis and A1c levels, to evaluate biomarkers' correlation with periodontal and diabetic conditions. A1c for each subject was tested chairside using a rapid A1c test during saliva collection. This specific research project aimed to determine whether electrochemical analysis using biosensors would lead to different results when testing WHS of patients with and without periodontitis; and for patients with different A1c levels. Electrochemical analysis of WHS was completed using Gamry potentiostat and Gamry software. Open circuit potential (OCP), electrochemical impedance spectroscopy (EIS), and cyclic voltammetry (CV) were analyzed. Using this data, the capacitance and resistance of salivary samples were calculated. Results: The evolution of open circuit potential, cyclic voltammetry and EIS data ( Resistance and Capacitance) exhibit a clear difference between the WHS of subjects with varying glycemic and periodontal status. Conclusion: The findings suggest that the salivary biochemical properties may vary with peridoonytal and glycemic status. These findings highlight the potential of using electrochemical analysis of whole human saliva as an adjunct diagnostic tool and for monitoring of periodontal disease risk in patients with varying levels of glycemic control.