{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:59:56Z","timestamp":1785200396438,"version":"3.55.0"},"reference-count":54,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T00:00:00Z","timestamp":1681430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Diagnostic evaluation with the aid of biomarkers has reached newer heights to assess disease activity. Salivary calcium, magnesium, and pH are one of the biochemical parameters which can be helpful in assessing the progression of periodontal disease. Smokers are at topnotch threat for having oral diseases, predominantly periodontal diseases. The aim of this study was to assess the salivary calcium, magnesium, and pH levels in smokers compared with non-smokers with chronic periodontitis. Materials and Methods: The current study was conducted on 210 individuals affected with generalized chronic periodontitis, with the age group between 25 and 55 years. Based on their smoking habit, an equal number of patients were categorized into two groups; namely, group I consisted of non-smokers and group II consisted of smokers. The clinical parameters that were measured included Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Loss (CAL). The biochemical variables that were evaluated in the current study included salivary calcium, magnesium, and pH using an AVL9180 electrolyte analyzer (Roche, Germany). The gathered data were analyzed with an unpaired t test was using SPSS 20.0. Results: A statistically significant higher PPD (p &lt; 0.01), CAL (p &lt; 0.05), and salivary calcium levels (p &lt; 0.001) were observed in the smokers\u2019 compared with their non-smoking counterparts. Among the biochemical parameters, calcium showed a significantly (p &lt; 0.001) higher level in smokers (5.79 \u00b1 1.76) in contrast to non-smokers (3.87 \u00b1 1.03). Additionally, a significant negative correlation (p &lt; 0.05) between calcium and PPD was observed in non-smokers, whereas a non-significant inverse relation (p &gt; 0.05) was seen in smokers. Conclusions: The present study indicates that the salivary calcium level can be a potential biochemical parameter to assess the progression of periodontal disease in smokers and non-smokers. Within the limitations of the current study, the salivary biomarkers appear to have an essential role in the identification and indication of the status of periodontal diseases.<\/jats:p>","DOI":"10.3390\/medicina59040765","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T09:23:43Z","timestamp":1681464223000},"page":"765","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Assessment and Correlation of Salivary Ca, Mg, and pH in Smokers and Non-Smokers with Generalized Chronic Periodontitis"],"prefix":"10.3390","volume":"59","author":[{"given":"Saad Mohammad","family":"Alqahtani","sequence":"first","affiliation":[{"name":"Department of Periodontics and Community Sciences (PCS), College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankar T.","family":"Gokhale","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Community Sciences (PCS), College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6173-3297","authenticated-orcid":false,"given":"Mohamed Fadul A.","family":"Elagib","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Community Sciences (PCS), College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1073-9920","authenticated-orcid":false,"given":"Deepti","family":"Shrivastava","sequence":"additional","affiliation":[{"name":"Department of Preventive dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghavendra Reddy","family":"Nagate","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Community Sciences (PCS), College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badar Awadh Mohammad","family":"Alshmrani","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Community Sciences (PCS), College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abduaziz Mohammed Abdullah","family":"Alburade","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Community Sciences (PCS), College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fares Mufreh Abdullah","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Community Sciences (PCS), College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0251-1253","authenticated-orcid":false,"given":"Anil Kumar","family":"Nagarajappa","sequence":"additional","affiliation":[{"name":"Department of Oral Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7565-3944","authenticated-orcid":false,"given":"Valentino","family":"Natoli","sequence":"additional","affiliation":[{"name":"Department of Dentistry, School of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain"},{"name":"Private Dental Practice, 72015 Fasano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5969-6810","authenticated-orcid":false,"given":"Kumar Chandan","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Oral Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"},{"name":"Department of Oral Medicine and radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s11306-017-1270-3","article-title":"The dental calculus metabolome in modern and historic samples","volume":"13","author":"Velsko","year":"2017","journal-title":"Metabolomics"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bibi, T., Khurshid, Z., Rehman, A., Imran, E., Srivastava, K., and Shrivastava, D. (2021). Gingival Crevicular Fluid (GCF): A Diagnostic Tool for the Detection of Periodontal Health and Diseases. Molecules, 26.","DOI":"10.3390\/molecules26051208"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.archoralbio.2015.03.004","article-title":"The functions of human saliva: A review sponsored by the World Workshop on Oral Medicine VI","volume":"60","author":"Dawes","year":"2015","journal-title":"Arch. Oral. Biol."},{"key":"ref_4","first-page":"347","article-title":"Potential application of human saliva as diagnostic fluid","volume":"31","author":"Castagnola","year":"2011","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1007\/s11306-015-0840-5","article-title":"The human saliva metabolome","volume":"11","author":"Dame","year":"2015","journal-title":"Metabolomics"},{"key":"ref_6","first-page":"9","article-title":"A study of analytical indicators of saliva","volume":"4","author":"Sonalee","year":"2012","journal-title":"Ann. Essences Dent."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.archoralbio.2011.06.013","article-title":"Potential uses of human salivary protein and peptide analysis in the diagnosis of disease","volume":"57","author":"Rahim","year":"2012","journal-title":"Arch. Oral. Biol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2221112","DOI":"10.1155\/2021\/2221112","article-title":"The Effect of Smoking on Salivary Calcium Levels, Calcium Intake, and Bleeding on Probing in Female","volume":"2021","author":"Tjahajawati","year":"2021","journal-title":"Int. J. Dent."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6615603","DOI":"10.1155\/2021\/6615603","article-title":"Quantitative Assessment of Gingival Inflammation in Patients Undergoing Nonsurgical Periodontal Therapy Using Photometric CIELab Analysis","volume":"2021","author":"Shrivastava","year":"2021","journal-title":"BioMed Res. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1600-0757.2008.00288.x","article-title":"Saliva as a diagnostic tool for periodontal disease: Current state and future directions","volume":"50","author":"Giannobile","year":"2009","journal-title":"Periodontol. 2000"},{"key":"ref_11","first-page":"195","article-title":"High salivary calcium level associated with periodontal disease in Indian subjects\u2014A pilot study","volume":"9","author":"Acharya","year":"2011","journal-title":"Oral. Health Prev. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5368\/aedj.2010.2.4.21-24.pdf","article-title":"Quantitative evaluation of salivary calcium, phosphorous, protein and Ph in health and diseased periodontium","volume":"2","author":"Sudhir","year":"2010","journal-title":"Ann. Essences Dent."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Shrivastava, D., Srivastava, K.C., Dayakara, J.K., Sghaireen, M.G., Gudipaneni, R.K., Al-Johani, K., Baig, M.N., and Khurshid, Z. (2020). BactericidalActivity of Crevicular Polymorphonuclear Neutrophils in Chronic Periodontitis Patients and Healthy Subjects under the Influence of Areca Nut Extract: An In Vitro Study. Appl. Sci., 10.","DOI":"10.3390\/app10145008"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4103\/SDJ.SDJ_72_21","article-title":"Comparison of gingival health status and salivary magnesium levels in smokers and nonsmokers","volume":"5","author":"Wijaya","year":"2021","journal-title":"Sci. Dent. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"461","DOI":"10.4103\/0976-237X.169846","article-title":"Assessment of salivary calcium, phosphate, magnesium, pH, and flow rate in healthy subjects, periodontitis, and dental caries","volume":"6","author":"Rajesh","year":"2015","journal-title":"Contemp. Clin. Dent."},{"key":"ref_16","first-page":"ZC58","article-title":"Estimation and comparison of salivary calcium, phosphorous, alkaline phosphatase and pH levels in periodontal health and disease: A cross-sectional biochemical study","volume":"10","author":"Patel","year":"2016","journal-title":"J. Clin. Diagn. Res. JCDR"},{"key":"ref_17","first-page":"305","article-title":"Comparative study on mineralization related intraoral parameters in periodontitis affected and periodontitis-free adults","volume":"98","author":"Karjalainen","year":"1990","journal-title":"Scand. J. Dent. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1034\/j.1600-051X.2002.290815.x","article-title":"Effects of smoking on periodontal tissues","volume":"29","author":"Calsina","year":"2002","journal-title":"J. Clin. Periodontol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/prd.12063","article-title":"Current perspective of the impact of smoking on the progression and treatment of periodontitis","volume":"67","author":"Nociti","year":"2015","journal-title":"Periodontol. 2000"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1034\/j.1600-051X.1999.260808.x","article-title":"Tobacco smoking and supragingival dental calculus","volume":"26","author":"Bergstrom","year":"1999","journal-title":"J. Clin. Periodontol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"196","DOI":"10.5455\/msm.2013.25.196-198","article-title":"Comparative analysis of smoking influence on periodontal tissue in subjects with periodontal disease","volume":"25","author":"Petrovic","year":"2013","journal-title":"Mater. Sociomed."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"252","DOI":"10.4103\/ijdr.IJDR_879_19","article-title":"Estimation of salivary calcium level as a screening tool for the osteoporosis in the post-menopausal women: A prospective study","volume":"31","author":"Wasti","year":"2020","journal-title":"Indian J. Dent. Res."},{"key":"ref_23","first-page":"ZC63","article-title":"Evaluation of correlation between salivary calcium, alkaline phosphatase and osteoporosis-a prospective, comparative and observational study","volume":"11","author":"Saha","year":"2017","journal-title":"J. Clin. Diagn. Res. JCDR"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1746-160X-2-44","article-title":"Salivary flow rate, pH, and concentrations of calcium, phosphate, and sIgA in Brazilian pregnant and non-pregnant women","volume":"2","author":"Rockenbach","year":"2006","journal-title":"Head Face Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1111\/j.1600-0765.1986.tb01476.x","article-title":"Calcium and phosphate concentrations and precipitate formation in whole saliva from smokers and non-smokers","volume":"21","author":"MacGregor","year":"1986","journal-title":"J. Periodontal Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2174\/1874210600802010089","article-title":"Effect of age on flow rate, protein and electrolyte composition of stimulated whole saliva in healthy, non-smoking women","volume":"2","author":"Sevon","year":"2008","journal-title":"Open Dent. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"461","DOI":"10.4103\/0972-124X.118317","article-title":"Salivary pH: A diagnostic biomarker","volume":"17","author":"Baliga","year":"2013","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_28","first-page":"397","article-title":"Salivary calcium concentration and periodontal health of young adults in relation to tobacco smoking","volume":"10","author":"Ivana","year":"2012","journal-title":"Oral. Health Prev. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1902\/jop.1967.38.6_part2.610","article-title":"The Gingival Index, the Plaque Index and Retention Index systems","volume":"38","author":"Loe","year":"1967","journal-title":"J. Periodontol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1749-6632.1993.tb18343.x","article-title":"Methods for collecting saliva","volume":"694","author":"Navazesh","year":"1993","journal-title":"Ann. N. Y Acad. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1177\/0192623307310947","article-title":"Metabolic profiling as a tool for understanding mechanisms of toxicity","volume":"36","author":"Clarke","year":"2008","journal-title":"Toxicol Pathol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1177\/0022034516661142","article-title":"Prediction of periodontal inflammation via metabolic profiling of saliva","volume":"95","author":"Kuboniwa","year":"2016","journal-title":"J Dent Res."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Gardner, A., Carpenter, G., and So, P.W. (2020). Salivary metabolomics: From diagnostic biomarker discovery to investigating biological function. Metabolites, 10.","DOI":"10.3390\/metabo10020047"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1177\/0022034519842853","article-title":"The saliva metabolome in association to oral health status","volume":"98","author":"Liebsch","year":"2019","journal-title":"J. Dent. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/0300-5712(88)90096-6","article-title":"Smoking, saliva and salivation","volume":"16","author":"Macgregor","year":"1988","journal-title":"J. Dent."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Cicho\u0144ska, D., Kusiak, A., Kocha\u0144ska, B., Ochoci\u0144ska, J., and \u015awietlik, D. (2022). Influence of Electronic Cigarettes on Selected Physicochemical Properties of Saliva. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph19063314"},{"key":"ref_38","first-page":"439","article-title":"Research on plasma and saliva levels of some bivalent cations in patients with chronic periodontitis (salivary cations in chronic periodontitis)","volume":"118","author":"Manea","year":"2014","journal-title":"Rev. Med. Chir. Soc. Med. Nat. Iasi"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1902\/jop.2006.050202","article-title":"The detection of salivary minerals in smokers and non-smokers with chronic periodontitis by the inductively coupled plasma-atomic emission spectrophotometry technique","volume":"77","author":"Erdemir","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.1600-051X.1995.tb00146.x","article-title":"Calcium and other salivary factors in periodontitis-affected subjects prior to treatment","volume":"22","author":"Sewon","year":"1995","journal-title":"J. Clin. Periodontol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Najeeb, S., Zafar, M.S., Khurshid, Z., Zohaib, S., and Almas, K. (2016). The Role of Nutrition in Periodontal Health: An Update. Nutrients, 8.","DOI":"10.3390\/nu8090530"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1111\/j.1600-051X.1998.tb02390.x","article-title":"Association between salivary calcium and oral health","volume":"25","author":"Sewon","year":"1998","journal-title":"J. Clin. Periodontol"},{"key":"ref_43","first-page":"ZC54","article-title":"Quantitative assessment of calcium profile in whole saliva from smokers and non-smokers with chronic periodontitis","volume":"9","author":"Varghese","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"350","DOI":"10.4103\/0972-124X.100909","article-title":"Effect of smoking on salivary composition and periodontal status","volume":"16","author":"Kolte","year":"2012","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_45","first-page":"122","article-title":"Comparison ofsalivary calcium level and ph in patients with aggressive periodontitis and healthy individuals: A clinico-biochemical study","volume":"15","author":"Gupta","year":"2016","journal-title":"Oral. Health Dent. Manag."},{"key":"ref_46","first-page":"84","article-title":"Assessment of Salivary Composition in Smokers and Non Smokers with Chronic Periodontitis","volume":"15","author":"Shashikanth","year":"2016","journal-title":"J. Dent. Med. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1902\/jop.1999.70.10.1240","article-title":"The effect of smoking and periodontal treatment on salivary composition in patients with established periodontitis","volume":"70","author":"Zuabi","year":"1999","journal-title":"J. Periodontol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.archoralbio.2003.11.004","article-title":"Salivary calcium concentration reflects skeletalosteoporotic changes in heavy smokers","volume":"49","author":"Sewon","year":"2004","journal-title":"Arch. Oral. Biol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4103\/ijdr.IJDR_387_19","article-title":"Assessment of salivary thiocyanate levels and pHin the saliva of smokers and nonsmokers with chronic periodontitis\u2014A comparative study","volume":"32","author":"Kumar","year":"2021","journal-title":"Indian J. Dent. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4103\/jorr.jorr_36_16","article-title":"Estimation and comparison of salivary calcium levels in healthy controls and patients with generalized gingivitis and chronic periodontitis","volume":"9","author":"Rane","year":"2017","journal-title":"J. Oral. Res. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1034\/j.1600-051x.2001.028004283.x","article-title":"Relationship of smoking to attachment level profiles","volume":"28","author":"Haffajee","year":"2001","journal-title":"J. Clin. Periodontol."},{"key":"ref_52","first-page":"e5586","article-title":"Distribution of periodontal pockets among smokers and Nonsmokers in patients with chronic periodontitis: A cross-sectional study","volume":"11","author":"Velidandla","year":"2019","journal-title":"Cureus J. Med. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"571590","DOI":"10.1155\/2012\/571590","article-title":"Periodontal status in smokers and nonsmokers: A clinical, microbiological, and histopathological study","volume":"2012","author":"Sreedevi","year":"2012","journal-title":"Int. J. Dent."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1902\/jop.1993.64.1.16","article-title":"Evidence for cigarette smoking as a major risk factor for periodontitis","volume":"64","author":"Haber","year":"1993","journal-title":"J. Periodontol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/765\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:16:03Z","timestamp":1760123763000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/765"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,14]]},"references-count":54,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["medicina59040765"],"URL":"https:\/\/doi.org\/10.3390\/medicina59040765","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,14]]}}}