{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:24:50Z","timestamp":1793035490225,"version":"4.5.0"},"reference-count":32,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cDun\u0103rea de Jos\u201d University from Gala\u021bi, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Peri-implantitis, a common biological complication of dental implants, is characterized by soft-tissue inflammation and progressive bone loss. Oxidative stress is increasingly implicated in its pathogenesis, yet the diagnostic potential of salivary redox biomarkers remains unclear. This study\u2019s objective was to assess the association between salivary malondialdehyde (MDA) and total antioxidant capacity (TAC) and peri-implant disease via a pre-registered, quantitative meta-analysis of previously published studies using predefined statistical criteria. Following a priori PROSPERO registration, we systematically searched PubMed, Scopus, and Web of Science (2004\u2013September 2025), extracted data in duplicate, and pooled effects using random-effects models; certainty of evidence was appraised with GRADE (Grading of Recommendations Assessment, Development and Evaluation) and risk of bias with ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions)\/QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2). Twelve studies were included qualitatively: seven (n = 726) contributed to MDA and five (n = 485) to TAC meta-analyses. Peri-implant disease was associated with elevated MDA (SMD = 1.64, 95% CI 1.39\u20131.88) and reduced TAC (SMD = \u22121.88, 95% CI \u22122.17 to \u22121.58); statistical heterogeneity was not detected, and results were robust to sensitivity and exploratory assay-based subgroup analyses. Salivary MDA and TAC show consistent, large, standardized differences in peri-implant disease; however, observational designs, assay variability, and the absence of validated diagnostic thresholds warrant cautious interpretation and prospective validation before clinical adoption.<\/jats:p>","DOI":"10.3390\/ijms262311269","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T14:17:23Z","timestamp":1763734643000},"page":"11269","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Salivary Oxidative Stress Biomarkers in Peri-Implant Disease: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1096-9280","authenticated-orcid":false,"given":"Paul \u0218erban","family":"Popa","sequence":"first","affiliation":[{"name":"Department of Dental Medicine, \u201cDun\u0103rea de Jos\u201d University Gala\u021bi, 800008 Gala\u021bi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Valeriu","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, \u201cDun\u0103rea de Jos\u201d University Gala\u021bi, 800008 Gala\u021bi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamel","family":"Earar","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, \u201cDun\u0103rea de Jos\u201d University Gala\u021bi, 800008 Gala\u021bi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Elisabeta","family":"Popa-Cazacu","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, \u201cDun\u0103rea de Jos\u201d University Gala\u021bi, 800008 Gala\u021bi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u0103d\u0103lina Nicoleta","family":"Matei","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, \u201cDun\u0103rea de Jos\u201d University Gala\u021bi, 800008 Gala\u021bi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S286","DOI":"10.1111\/jcpe.12957","article-title":"Peri-Implant Diseases and Conditions: Consensus Report of Workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"45","author":"Berglundh","year":"2018","journal-title":"J. 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