Salivary Profiling Reveals Distinct Immune Activity in Periodontitis and Peri-Implantitis

Periodontitis and peri-implantitis are chronic inflammatory diseases driven by biofilm dysbiosis and characterized by soft tissue inflammation and progressive bone loss. While the two conditions share clinical similarities, peri-implantitis is often associated with more rapid and extensive tissue destruction. Traditional clinical parameters such as probing depth and bleeding on probing reflect cumulative damage and are limited in their ability to evaluate ongoing immune activity. Saliva has emerged as a promising, non-invasive diagnostic medium capable of reflecting real-time inflammatory processes, yet relatively few studies have directly compared salivary immune profiles between periodontal and peri-implant diseases. The goal of this study was to evaluate whether peri-implantitis and periodontitis demonstrate distinct salivary immune-cell signatures and to explore how these patterns relate to clinical findings. This cross-sectional pilot study included 21 systemically healthy individuals recruited from the University of Illinois Chicago College of Dentistry and divided into four groups: peri-implantitis (n = 5), periodontitis (n = 5), peri-implant health (n = 6), and periodontal health (n = 5). Clinical measurements included probing pocket depth, bleeding on probing, plaque/calculus indices, and crevicular/sulcular fluid volume measured using Periotron readings. Unstimulated saliva samples were processed and analyzed using flow cytometry to quantify adaptive immune populations, including total T cells (CD3⁺), Th1 cells (CD4⁺IFN-γ⁺), Th17 cells (CD4⁺IL-17⁺), T cells (CD4⁺IL-10⁺) and B cells (CD19⁺). Group differences were assessed using ANOVA. Peri-implantitis demonstrated the highest overall inflammatory burden, with greater probing depths and higher Periotron values compared with the other groups. Salivary immune profiling revealed an increase in adaptive immune activation from health to disease. Both periodontitis and peri-implantitis showed elevated total T-cell frequencies and increased pro-inflammatory CD4⁺ subsets relative to healthy controls. Peri-implantitis, however, consistently trended toward higher immune activation, with the greatest frequency of total T cells, stronger Th1 and Th17 polarization, and higher relative B-cell representation. In contrast, IL-10–producing CD4⁺ T cells were highest in periodontal health and progressively reduced across disease states, with significantly lower frequencies observed in peri-implant health and peri-implantitis. The absence of a difference between peri-implant health and peri-implantitis groups suggests diminished regulation at implant sites irrespective of the presence of clinical disease. These findings support the concept that salivary immune profiling can capture biologically meaningful differences across periodontal and peri-implant disease states. Both conditions demonstrated increased adaptive immune activation compared with health, while peri-implantitis exhibited a more pronounced inflammatory phenotype characterized by increased pro-inflammatory polarization and reduced regulatory T-cell–associated activity. These results reinforce the potential of saliva as a practical, non-invasive medium for immune monitoring and provide preliminary support for immune-based diagnostics in periodontology. With further validation in larger cohorts, salivary immune profiling may help inform future biomarker-driven approaches for early detection and personalized management of periodontal and peri-implant diseases.

Author dc:creator

• Laura S. Pesquera Colom (24399485)

• Salivary Immune Profiling
• Periodontal Disease
• Peri-Implantitis

Statement dc:rights

• In Copyright

DOI dc:identifier

https://doi.org/10.25417/uic.32993921.v1

OAI identifier oai:identifier

oai:figshare.com:article/32993921