Overview
This observational clinical study aims to investigate the relationship between the HALP score (Hemoglobin × Albumin × Lymphocyte / Platelet), several blood-based inflammatory indices (including NLR, PLR, LMR, and SII), and salivary MMP-8 levels in individuals with periodontal health, gingivitis, and stage III/IV periodontitis. The study also evaluates how these biomarkers relate to healing following non-surgical periodontal therapy.
A total of 180 participants aged 18-65 years will be included: 50 healthy individuals, 50 patients with gingivitis, and 80 patients with stage III/IV periodontitis. All participants will undergo periodontal clinical examination and provide blood and saliva samples at baseline. Individuals in the gingivitis and periodontitis groups will receive standard non-surgical periodontal treatment (full-mouth debridement) and will return for a 3-month follow-up visit, where periodontal measurements will be repeated. In the periodontitis group, an additional blood sample will be collected at the 3-month follow-up visit.
The primary objective is to determine whether baseline HALP score, systemic inflammatory indices, and salivary MMP-8 levels differ between participants who show good versus poor healing after treatment. Secondary objective include comparing biomarker levels across periodontal status groups. The findings may contribute to early prediction of treatment response and personalized periodontal care.
Description
Following baseline assessments, participants in the gingivitis and periodontitis groups will receive standard non-surgical periodontal therapy. Periodontal clinical measurements will be repeated at the 3-month follow-up visit in these groups. In accordance with the existing ethics committee approval and following further feasibility assessment, an additional blood sample will be collected at the 3-month follow-up visit exclusively from participants in the periodontitis group.
Eligibility
Inclusion Criteria:
- Adults aged 18-65 years
- Ability to provide informed consent
- No systemic diseases or conditions affecting periodontal status
- For Healthy Group: Probing depth ≤3 mm, no attachment loss, no radiographic bone loss
- For Gingivitis Group: Gingival inflammation and bleeding on probing without attachment loss or bone loss
- For Periodontitis Group: Stage III or stage IV periodontitis according to 2018 classification
- No periodontal treatment within the past 6 months
- Willingness to attend follow-up visits
Exclusion Criteria:
- Systemic diseases influencing periodontal inflammation (e.g., diabetes, autoimmune disorders)
- Current pregnancy or lactation
- Use of antibiotics, anti-inflammatory medications, or immunosuppressive drugs within the last 3 months
- Smokers or individuals using tobacco products
- History of periodontal surgery in the last 6 months
- Presence of fewer than 20 natural teeth
- Any condition that may interfere with study participation or data reliability