Evaluation of Tumor Necrosis Factor α (TNF-α) in Gingival Crevicular Fluid and Serum Before and After Phase I Therapy with Subgingival delivery of Hyaluronic Acid in Chronic Periodontitis Patients

The aim of this study was to estimate the levels of TNF-α in serum and gingival crevicular fluid, in patients with chronic periodontitis (CP), before and after phase I therapy with subgingival delivery of Hyaluronic acid (Gengigel Gel). A total of thirty subjects were included in this study; 20 CP patients as a study group (group I) and 10 systemically healthy subjects with clinically healthy gingiva as a control group (group II). The nonsurgical periodontal therapy (SRP) + HA gel were done in group I. Periodontal parameters, including PI, GI, BOP, PD and the CAL, were recorded. GCF and serum were collected from all individuals included in the study; the first sample was collected from all groups (study and control) before treatment. The second sample was collected 4 weeks after subgingival delivery of Hyaluronic acid & phase I therapy from group I. Levels of TNF-α in GCF and serum were quantified using ELISA. The results showed a statistically significant reduction in total levels of TNF-α in serum and TNF-α in GCF in study group after application of Hyaluronic acid with phase I therapy. Results also showed all clinical parameters were significantly improved after application of Hyaluronic acid with phase I therapy in groups I (p<0.001). Scaling and root planing (SRP) is the mainstay of treatment of periodontal diseases, furthermore subgingival application of Hyaluronic acid gel with SRP were effective in improving clinical parameters in CP patients. TNF-α level in serum and GCF are reduced after phase I therapy with application of Hyaluronic acid.