Reduced systemic inflammatory mediators after treatment of chronic gingivitis

OBJECTIVE: To assess the changes in the level of C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-alpha) in gingival crevicular fluid (GCF) after treatment of chronic gingivitis in systemically healthy individuals.

METHODS: This is a clinical trial conducted at Case Western Reserve University, Cleveland, Ohio, United States of America from February to December 2011. A total of 41 systemically healthy subjects were assigned to 2 groups according to the severity of gingival inflammation. Group I consisted of 18 subjects who had mild gingival inflammation; and group II consisted of 23 with more severe gingival inflammation. Periodontal assessment consisted of gingival index (GI), probing depths (PD), and GCF volume. Four to six weeks after prophylaxis and oral hygiene instruction, the same measurements were repeated. The level of CRP and TNF-alpha in the GCF was determined using enzyme-linked immunosorbent assays.

RESULTS: A statistically significant reduction in the mean CRP and TNF-alpha levels after the treatment was found in the severe, but not in the mild gingivitis group. Both groups showed a statistically significant reduction in GI, PD, and periotron readings after the treatment.

CONCLUSION: Treatment of severe chronic gingivitis reduces the levels of CRP and TNF-alpha in GCF of otherwise systemically healthy individuals, which could have an impact on preventing or controlling future or existing systemic disease conditions.