Beyond traditional diagnosis: aptamer-based microRNA detection for the early diagnosis of periodontitis

Periodontitis is a prevalent, chronic inflammatory disease linked to microbial dysbiosis and host immune response, leading to destruction of the tooth-supporting structures. Traditional diagnostic methods, though widely used, are limited in their ability to detect early-stage disease and monitor real-time progression. Recent research highlights the significance of microRNAs (miRNAs) as non-invasive biomarkers, particularly in saliva and gingival crevicular fluid (GCF), for the early detection of periodontitis. This review explores the emerging role of aptamer-based biosensors in miRNA detection, presenting them as highly specific and stable alternatives to antibodies. Aptamers, single-stranded DNA or RNA oligonucleotides, exhibit high affinity for diverse targets and can be integrated into point-of-care testing (POCT) diagnostic devices. These aptasensors enable rapid, sensitive, and cost-effective detection of miRNAs such as miR-146a and miR-155, which are implicated in inflammatory regulation and disease progression. The review outlines advancements in aptamer synthesis methods, including Systematic evolution of ligands by exponential enrichment (SELEX) and computational approaches, and discusses the potential of aptamer-drug conjugates for therapeutic use. Despite challenges like nuclease degradation and rapid renal clearance, innovations in nanotechnology and AI-driven aptamer design are paving the way for personalized, non-invasive diagnostics in periodontitis. This article advocates for the integration of aptamer-based technologies into clinical practice, with emphasis on early intervention, real-time monitoring, and improved patient outcomes.