Neutrophil-to-lymphocyte ratio in periodontitis and after subgingival instrumentation in Cameroon: a controlled observational study with prospective follow-up

Abstract

Periodontitis is associated with low-grade systemic inflammation, and the neutrophil-to-lymphocyte ratio (NLR) is a low-cost blood-cell-derived inflammatory index. Evidence from sub-Saharan African populations remains limited. This study compared baseline NLR between Cameroonian adults with and without periodontitis and described short-term NLR changes after subgingival instrumentation (SI). This controlled observational study comprised a baseline comparison of 102 adults selected according to pre-existing periodontal status (51 with stage II-IV periodontitis and 51 periodontally healthy controls) and prospective follow-up of the periodontitis group. Clinical and hematological parameters were measured at baseline. Participants with periodontitis received full-mouth SI as clinically indicated care independent of study participation and were reassessed one month after completion of the final session. Baseline NLR was log-transformed and analyzed using multivariable linear regression adjusted for age, sex, and education level, with heteroscedasticity-consistent standard errors. At baseline, median NLR was 1.15 [1.00-1.25] in the periodontitis group and 0.89 [0.70–0.98] in controls. After adjustment, the geometric mean NLR was 1.38 times higher in the periodontitis group (95% CI 1.27–1.50; p < 0.001). One month after SI, mean NLR decreased from 1.13 ± 0.18 to 0.89 ± 0.19 (mean change − 0.24, 95% CI -0.25 to -0.23; p < 0.001). Adults with periodontitis had higher baseline NLR than healthy controls, and a lower NLR was observed one month after SI in the periodontitis group. This temporal finding warrants confirmation in controlled studies evaluating the potential role of NLR in periodontal monitoring.

The authors' abstract, as published at the source. BMC Oral Health, 2026 · DOI ↗