Effects of vector ultrasonic system debridement and conventional instrumentation on the levels of TNF-α in gingival crevicular fluid of patients with chronic periodontitis.

BACKGROUND: Tumor necrosis factor alpha (TNF-α) is an inflammatory mediator whose levels are increased in the gingival crevicular fluid and blood serum in the case of chronic periodontitis.

OBJECTIVES: The aim of this study was to determine the effect of vector ultrasonic system (VUS) on the levels of TNF-α in gingival crevicular fluid (GCF) and the clinical parameters in patients with chronic periodontitis.

MATERIAL AND METHODS: The study protocol was conducted using split-mouth design in 30 patients with chronic periodontitis. VUS and scaling and root planing (S/RP) were applied separately to 2 quadrants, including the upper and the lower jaws. At baseline and after 6 months, clinical parameters including plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) were recorded, and concentrations of TNF-α in GCF were determined by enzyme-linked immunosorbent assay (ELISA). Intergroup comparisons were evaluated by the independent Students' t-test, and the Pearson correlation was used to determine the relationship between parameters. The level of significance was set at 5%.

RESULTS: Both treatment modalities provided statistically significant improvements in clinical periodontal parameters and TNF-α levels after 6 months (p < 0.05). Also, there were no significant correlations between the TNF-α levels in GCF and the clinical parameters in both treatment group at baseline and at the end of 6 months period (p > 0.05).

CONCLUSIONS: The use of the vector ultrasonic system in the non-surgical treatment of chronic periodontitis presents beneficial improvements for the clinical attachment level and the probing pocket depth as well as TNF-α levels in GCF.