Association Between Salivary High-Sensitivity C-reactive Protein Concentrations and Clinical Stage of Periodontitis...

Background Periodontitis is a chronic inflammatory disease associated with both local tissue destruction and systemic inflammatory responses. Salivary high-sensitivity C-reactive protein (hs-CRP) has emerged as a promising non-invasive biomarker, but its association with periodontal disease severity remains insufficiently investigated in Indian populations. Objective To evaluate the association between salivary hs-CRP concentrations and the clinical stage of periodontitis in an Indian population and to examine their relationship with established periodontal clinical parameters. Methods This institution-based cross-sectional analytical study included 150 adults equally allocated into periodontally healthy, Stage I-II periodontitis, and Stage III-IV periodontitis groups (n = 50 each). Comprehensive periodontal examinations were performed according to the 2017 World Workshop Classification, and unstimulated whole saliva samples were collected for hs-CRP estimation using a high-sensitivity enzyme-linked immunosorbent assay (ELISA). Group comparisons were performed using one-way analysis of variance(ANOVA) with Bonferroni post hoc analysis. Correlation analyses and multiple linear regression were conducted to evaluate associations between salivary hs-CRP concentrations and clinical periodontal parameters after adjustment for age, sex, and body mass index (BMI). Results Salivary hs-CRP concentrations increased significantly with advancing periodontitis stage (p < 0.001). Significant positive correlations were observed between hs-CRP and periodontal clinical parameters, particularly clinical attachment level and probing pocket depth. Periodontitis stage remained an independent predictor of salivary hs-CRP after multivariable adjustment. Conclusions Salivary hs-CRP concentrations increase progressively with advancing clinical stage of periodontitis and are independently associated with periodontal disease severity. These findings support the use of salivary hs-CRP as a simple, non-invasive adjunctive biomarker for periodontal assessment and provide contemporary evidence using the 2017 World Workshop Classification in an Indian population. Prospective multicenter studies are warranted to validate its clinical utility and integration into multimarker saliva-based diagnostic strategies.