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Methods: Forty-one systemically healthy subjects(25 males and 16 females, mean age 26.5± 6.7 years) participated in the study and were divided into two groups according to the severity of gingivitis. Group I consisted of 18 subjects who had mild gingivitis (mean GI >1.5) and group II consisted of 23 having severe inflammation (mean GI≥1.5) according to Loe and Silness Index. Periodontal assessment included gingival index (GI), probing depths (PD) and GCF volume measured by Periotron. GCF was collected from at least 8 inflamed sites. Prophylaxis was performed and oral hygiene instructions given. Four to six weeks after prophylaxis, the same measurements were repeated. GI, PD and GCF volume were conducted before and after the treatment. ELISA test was used to determine the levels of TNF- α and CRP in the pooled GCF samples of each subject. t-test was used to determine if there is statistically significant difference between the two groups regarding TNF- α and CRP levels before and after treatment.
Results: In the severe gingivitis group, there was statistically significant difference (p<.05) in the mean TNF- α and CRP levels before and after the treatment, 58.08±14.66, 46.60±11.5 pg/ml; 0.26±0.08, 0.22±0.04 ng/ml respectively. In the mild gingivitis group, there was no significant difference (p>0.05) 54.45±7.36, 50.54±6.92 pg/ml; 0.24±0.06, 0.28±0.16 ng/ml. In both groups there was statistically significant reduction (p<0.05) in GI, PD and Periotron readings before and after the treatment.
Conclusions: In systemically healthy subjects, treatment of severe chronic gingivitis reduces the levels of TNF- α and CRP in GCF. Therefore, reduction of these inflammatory markers may help control existing systemic inflammation.
Keywords: Gingivitis, Inflammation, Inflammatory mediators, Periodontal disease and Prophylaxis