Comparison and Estimation of Salivary sTREM-1 and IL-1β in Periodontitis and Diabetes Mellitus Patients before and after Non-surgical Periodontal Therapy using Hyaluronic Acid and Diode LASER: A Clinical Trial

Background Periodontal disease is a chronic inflammatory disease that activates the innate immune response. Activation of the TREM-1 signaling pathway promotes the synthesis of inflammatory cytokines like interleukin-1 beta (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8). Hyaluronic acid (HA) can be used to treat periodontitis as an adjunct to mechanical debridement due to its healing properties. Objectives To evaluate and compare soluble triggering receptor expressed on myeloid cells (sTREM-1) and IL-1β in periodontitis patients with and without diabetes mellitus before and after nonsurgical periodontal therapy using conventional root planing and adjuncts like HA (Gengigel ® ) and diode LASER (940 nm). Materials and Methods Chronic periodontitis patients were allocated to groups based on with and without diabetes mellitus (groups I and II), respectively. Assessment of periodontal parameters: periodontal probing depth (PPD), clinical attachment loss (CAL), plaque index (PI), gingival bleeding index (GBI), and periodontal inflammatory surface area (PISA) index were done. About 5 mL of unstimulated whole saliva was collected from every patient at baseline and 1 month. Patients were subgrouped based on the treatment protocol (subgroup A: conventional scaling and root planing (SRP), subgroup B: SRP + HA (0.8% Gengigel ® ), and subgroup C: SRP + 940 nm diode LASER). The primary and secondary outcomes before and after therapy were determined. Results Intragroup comparison of group I showed the statistical significance of parameters in subgroups B and C. Intragroup comparison of group II in all three subgroups. Intergroup comparison of groups II and III showed the statistical significance of all periodontal parameters and salivary biomarker levels in A–C subgroups. Conclusion Therefore, within the study’s limitations, the use of adjuncts to nonsurgical periodontal therapy in chronic periodontitis had an additional improvement in all clinical parameters and salivary biomarkers over conventional root planing.