The Role of Epigenetic and Biological Biomarkers in the Diagnosis of Periodontal Disease: A Systematic Review Approach

Erin Faulkner, Adelaide Mensah, Aoife M. Rodgers, Lyndsey R. McMullan, Aaron J. Courtenay

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)
119 Downloads (Pure)


The aim of this systemic review was to collate and analyze existing data from published literature sources to identify the current understanding of the role of epigenetic and biological biomarkers in periodontal disease and diagnostics. A comprehensive searching strategy was undertaken in Embase, Medline, The Dentistry and Oral Sciences and CINAHL databases. Grey literature searching strategies were also employed. Articles published in the English language between 2017–2020 were included. A total of 1014 studies were returned of which 15 studies were included. All included articles were cross-sectional, case–control studies. Relevant data were extracted according to various demographic and methodological factors including cohort size, oral biofluid sampled, number of examiners, smoking status and reported outcomes. A measure of the biomarker levels and corresponding significance were documented where possible. This review identified that exRNA has the greatest diagnostic potential, with four biomarkers (SPRR1A, lnc-TET3-2:1, FAM25A, CRCT1) displaying sensitivity of >71% and specificity of 100% in the assessed samples (p < 0.001) for gingivitis. This work also identifies the need for a unified approach to future research to draw meaningful comparison. Further investigations are warranted to definitively validate exRNA data and for the development of an exRNA-specific point-of-care diagnostic test.

Original languageEnglish
Article number919
Pages (from-to)1-29
Number of pages29
Issue number4
Early online date7 Apr 2022
Publication statusPublished online - 7 Apr 2022

Bibliographical note

Funding Information:
The authors are grateful to the library directorate of Ulster University for their technical support at various stages of the study.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • periodontal disease
  • epigenetic
  • biomarkers
  • systematic
  • review
  • exRNA
  • gingival crevicular fluid


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