**6. Future recommendations**

Periodontal disease is already a very common problem in many countries; due to the above, the monitoring and reduction of the progress of periodontitis through surveillance and health promotion are part of the national health goal of countries like the United States [98].

Due to this, there has been an exhaustive search in recent years of biomarkers obtained from various sources, with saliva being the most used; however, we believe that new studies should include groups of patients with gingivitis on a daily basis, since this is considered an intermediate phase in which the patient can (if he/she carries out good dental hygiene and continues the treatment) stop the development of periodontitis [42], so that limit levels of these biomarkers may be detected.

In addition to this, numerous studies have shown so far that among the best options for biomarkers are proteins such as IL-1β, MMP-8, and ICTP.

From our point of view, we should also include and explore molecules such as miRNAs and other noncoding RNAs such as lncRNA and circRNA, in addition to the classical molecules that are already known to directly participate in the development of inflammatory pathology, since the study of these molecules could yield new perspectives on the development and progression of periodontal disease, which at some point may have important applications as biomarkers with leading activity in the development and manifestation of periodontitis.
