Effect of Surgical Flap on IL-1β and TGF-β Concentrations in the Gingival Crevicular Fluid of Patients with Moderate to Severe Chronic Periodontitis

Background: Growth factors play a major part in wound healing in many tissues including the periodontium. Transforming growth factor-beta 1 (TGF-beta 1) is one of these factors present in the gingival crevicular fluid. In addition, it is considered as one of the most important anti-inflammatory cytokines. Interleukin-1 beta is a proinflammatory cytokine that presents itself in gingival inflammation and the GCF. Such factors might be of value as prognostic markers of wound healing activity and the therapeutic progress following flap surgery. Objective: The aim of this study was to evaluate the effect of surgical flap on the concentration of IL-1 beta and TGF-beta in the GCF of patients with moderate to severe chronic periodontitis. Methods: The GCF samples were collected, using the Perio-Paper strip at phase 1 (pre-surgery), phase 2 (4th week post surgery) and phase 3 (12th week post surgery) from 20 sites of 10 patients undergoing flap surgery. After the elution, IL-1 beta and TGF-beta concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Results: The mean TGF-beta and IL-1 beta concentration decreased from phase 1 to phase 3 (p<0.05). There were no significant statistical correlations between IL-1 beta and TGF-beta 1 concentrations in the 3 assessment phases. There was a significant statistical correlation between TGF-beta 1 concentrations and the Plaque Index (PI) in phase 2 (p<0.05). There was a significant statistical correlation (p<0.05) between IL-1 beta and TGF-beta 1 concentration and the probing pocket depth (PPD). Conclusion: The flap surgery has a significant effect on decreasing IL-1 beta concentration. In the case of TGF-beta 1, probably the decrease in the concentration after treatment might be due to the removal of the inflammatory stimulants.