Inflammatory Biomarker Profiles in Odontogenic Infections: Evaluation of C-reactive Protein (CRP), Procalcitonin, WBC Count, and Neutrophil-to-Lymphocyte Ratio

Introduction: Odontogenic infections range from localized abscesses to severe, life-threatening conditions involving deep fascial spaces and systemic complications. Early identification of disease severity is essential for appropriate management and prevention of adverse outcomes. Inflammatory biomarkers, such as C-reactive protein (CRP), procalcitonin (PCT), white blood cell (WBC) count, and neutrophil-to-lymphocyte ratio (NLR), provide objective indicators of systemic infection and may aid in prognostic assessment. This study aimed to evaluate the levels of CRP, PCT, WBC count, and NLR in patients with odontogenic infections and determine their association with disease severity and clinical outcomes. Materials and methods: This prospective cohort study included 50 patients with odontogenic infections who were admitted to the Jawahar Medical Foundation's AC Patil Memorial (ACPM) Dental College, Dhule, India, between January and December 2023. Severity was classified into four groups using a structured scoring system. Blood samples were collected upon admission to determine CRP, PCT, WBC count, and NLR levels. Statistical analysis was performed using the Kruskal-Wallis test, Spearman correlation, Mann-Whitney U test, regression analysis, and receiver operating characteristic (ROC) curve analysis. Results: The mean age was 38.5 ± 14.2 years, with a male predominance. Median CRP was 72 mg/L, PCT 0.38 ng/mL, mean WBC 12.8 ± 3.8 ×103/µL, and NLR 7.2 ± 4.3. All biomarkers increased significantly with disease severity (p < 0.001). PCT showed the strongest correlation with disease severity (ρ = 0.60), followed by NLR (ρ = 0.56). Patients with complications had significantly higher biomarker levels (p < 0.001). PCT demonstrated the highest predictive value for complications (odds ratio (OR) = 3.20). ROC analysis showed the highest accuracy for PCT (area under the curve (AUC) = 0.89), followed by NLR (0.86) and CRP (0.82). Conclusion: Inflammatory biomarkers, particularly PCT and NLR, are reliable indicators of disease severity and predictors of clinical outcomes in odontogenic infections, supporting their use in early risk stratification and management.