Oral-fluid inflammatory and oxidative-stress biomarkers for peri-implantitis in Asian adults: a systematic review and stratified random-effects meta-analysis.

Peri-implantitis (PI) is an inflammatory condition where oral-fluid biomarkers can reflect disease - associated host responses. This meta - analysis evaluated biomarker differences between PI and healthy conditions in Asian adults, focusing on inflammatory cytokines (IL - 1β, IL - 6, TNF - α) and SIRT1 in peri - implant gingival crevicular fluid and saliva. Five databases were searched until August 2025. Random - effects models were used for pooled analyses, and relevant indicators were calculated. Thirteen studies were included. IL - 1β, IL - 6, and TNF - α were significantly higher in PI with low heterogeneity and stable findings. SIRT1 showed potentially favorable discriminatory performance but with limited evidence. Biomarker type affected effect - size variation, and mild small - study asymmetry for IL - 6 did not change overall conclusions. Overall, IL - 1β, IL - 6, and TNF - α can be candidate adjunctive biomarkers for PI assessment in Asian populations. SIRT1 is promising, but its diagnostic relevance conclusions are preliminary and need validation. Current evidence is limited. Further prospective studies in diverse populations and validation of clinically applicable thresholds and cost - effectiveness are needed before broader clinical translation.