The role of azurocidin and its implications in periodontal and peri-implant disease: A systematic review

Abstract

Objectives This systematic review aimed to explore the role of Azurocidin (Azu) in the pathogenesis of periodontal and peri-implant disease and its potential use as an inflammatory biomarker. Materials and methods Four electronic databases were used for study identification: PubMed, Google Scholar, ScienceDirect, and Scopus from Oct 10, 1991 to Jul 15, 2024. Study selection and data extraction were performed in a blinded and independent manner. The Joanna Briggs Institute (JBI) tool was used to assess the quality of cross-sectional articles, and the Newcastle-Ottawa scale was used to assess cohort studies. Results Out of 222 identified articles, nine studies met the inclusion criteria. These studies included 462 participants: 156 with healthy teeth and implants and 306 with periodontal conditions such as gingivitis, periodontitis, apical periodontitis, peri-implant mucositis, and peri-implantitis. A total of 1313 samples were analyzed (163 saliva, 118 PICF, 1003 GCF, 11 gingival tissue, and 18 infected root canals). ELISA was the most common method for azurocidin analysis (66.6 %), followed by LC-MS/MS (33.3 %), nLC-MS/MS (11.1 %), and Western Blot (11.1 %). Azu levels were consistently elevated in individuals with periodontitis compared to periodontally healthy subjects. Conclusions Azu may contribute to the inflammatory processes in periodontal and peri-implant diseases. Although elevated levels are observed in periodontitis, its diagnostic value remains unclear due to limited and heterogeneous data.