This case–control study aimed to investigate the relationship between the hypoxia‐related biomarker hypoxia‐inducible factor‐1α (HIF‐1α) and the epithelial‐mesenchymal transition (EMT)–associated markers E‐cadherin (E‐CAD) and N‐cadherin (N‐CAD) in saliva among smokers and nonsmokers with and without periodontitis and to assess their association with clinical periodontal parameters.
A case–control study was conducted, including 88 participants equally allocated into four groups (
Salivary E‐CAD and N‐CAD levels were significantly higher in the periodontitis groups than in the healthy groups (
Salivary E‐CAD and N‐CAD were significantly altered in periodontitis and demonstrated greater potential than HIF‐1α for reflecting periodontal disease status. The absence of significant differences in salivary HIF‐1α levels among the study groups may indicate limited ability to reflect localized periodontal hypoxic changes. HIF‐1α also showed limited and inconsistent associations with EMT‐related biomarkers, with a significant positive correlation observed only between HIF‐1α and N‐CAD in the periodontitis group. Smoking was associated with alterations in biomarker profiles, particularly E‐CAD levels. Overall, salivary EMT–related biomarkers may serve as promising noninvasive indicators of periodontal disease, although further validation is required.