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-alpha) 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-alpha 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-alpha 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-alpha levels after 6 months (p < 0.05). Also, there were no significant correlations between the TNF-alpha 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-alpha levels in GCF.