Comparative evaluation of various blood cell ratios as potential diagnostic inflammatory biomarkers of periodontal disease and their correlation with disease severity: A cross- sectional study.

A clear relationship exists between persistent low- grade systemic inflammation and severe- advanced periodontitis (Hajishengallis 2015). An array of inflammatory biomarkers has been studied and their association with severe periodontitis has been reported. Leukocyte ratios like (Neutrophil Lymphocyte Ratio) NLR and Platelet Lymphocyte Ratio (PLR) can be considered as inflammatory biomarkers that could provide a new insight into the relationship between periodontitis and systemic diseases. SII and SIRI has been reported an effective biomarker for predicting prognosis of various kind of cancer. However, the prognostic role of these blood markers in severe periodontitis patients remains unclear. Identifying a reliable and easily obtainable inflammatory indicator would greatly facilitate the prevention and control of periodontitis. Variables such as age, gender, smoking status, alcoholism and oral hygiene habits (frequency of tooth brushing and use of other oral hygiene aids), socioeconomic status (as per revised Kuppuswamy scale 2022) to be recorded for all the participants. After that, all the subjects will undergo a standardized medical examination that included assessing height, weight, body temperature, blood pressure measurements. Body mass index (BMI) will be calculated as weight in kilograms upon height squared in meter. Clinical parameters for evaluating periodontal status will be recorded. Complete blood counts will be obtained and used for calculating SII, SIRI, NLR and PLR using a fully automated analyzer. Data  obtained will be analyzed statistically.