Reactive oxygen species and periodontal disease: Current biomarkers, diagnostic potential and future perspectives (Review)

Periodontitis is a chronic inflammatory disease primarily driven by bacterial infection, leading to the progressive destruction of periodontal tissues. Recent evidence implicates reactive oxygen species (ROS) in mediating oxidative stress and tissue damage.  The present review discusses the diagnostic potential of ROS‑related biomarkers in periodontal disease, focusing on key markers, such as malondialdehyde, 8‑hydroxydeoxyguanosine and advanced glycation end products. Current studies highlight the correlation between elevated ROS biomarkers and the severity of periodontitis, suggesting their utility in early diagnosis and monitoring of disease progression. Furthermore, the present review discusses the variability in antioxidant levels, such as superoxide dismutase and glutathione, as well as their implications for periodontal health. Despite promising findings, challenges remain in standardizing biomarker assays and understanding the complex interplay between oxidative stress and periodontal disease. ROS‑related biomarkers have potential as non‑invasive diagnostic indicators for periodontitis. The standardization of assay methods and further research are required to facilitate their clinical application. Relevant literature was sourced through searches in databases including PubMed, Google Scholar, Scopus and Web of Science. The focus of the present review was placed on clinical and experimental studies published recently on ROS and periodontitis. The selection included randomized controlled trials, clinical trials and well conducted narrative reviews. The search strategy included the use of the following MeSH terms: Periodontitis, reactive oxygen species, oxidative stress, salivary biomarkers and antioxidants.