GCF HIF-1α, VEGF and TNF-α Levels in G-AgP Patients Before and After Periodontal Treatment.

2019-07-19 10:43:34 | BioPortfolio


Hypoxia-inducible angiogenic pathway involving hypoxia inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor (VEGF) and tumour necrosis factor- alpha (TNF-α) may regulate the several biological processes related to inflammation. Generalized aggressive periodontitis (G-AgP) is a rare but highly destructive form of inflammatory periodontal disease. The present study aimed to assess the effect of non-surgical periodontal treatment on gingival crevicular fluid (GCF) HIF-1α, VEGF and TNF-α levels in G-AgP patients. 20 G-AgP and 20 periodontally healthy subjects were enrolled. At baseline, GCF samples were collected and whole mouth clinical periodontal parameters were recorded. G-AgP patients received non-surgical periodontal treatment. Clinical parameters and GCF cytokines were re-measured at 1 and 3 months after treatment. GCF HIF-1α, VEGF and TNF-α levels were analyzed by ELISA. Data were analyzed using appropriate statistical tests.


Study Population and Clinical Examination

A total of 40 individuals were recruited for the present study. Inclusion criteria included: 1) aged 25 to 45 years 2) non-smokers with no history of smoking 3) having at least 20 natural teeth. Exclusion criteria were as follows: 1) having any diagnosed medical disorders such as diabetes mellitus, cardiovascular diseases, rheumatoid arthritis, immunological and mucocutaneous diseases 2) usage of antibiotics, non-steroidal anti-inflammatory drugs and immunosuppressive agents within the past 6 months 3) having any non-inflammatory destructive periodontal disease 4) nonsurgical/surgical periodontal therapy received in the past year 5) having a restorative and endodontic treatment requirement 6) having orthodontic appliances or a removable partial denture 7) pregnant/ lactating/ postmenopausal females.

The whole mouth clinical periodontal examination included measurement of probing depth (PPD), clinical attachment level (CAL), presence of bleeding on probing (BOP), gingival index (GI) and plaque index (PI) at 6 sites per tooth, except the third molars. The presence and type of the alveolar bone loss were assessed on the digital panoramic radiograph in each participant, which was supplemented with periapical radiographs if necessary.

Periodontal status of each patient was evaluated by a single calibrated periodontists with a manual probe. The diagnosis of G-AgP or periodontally health was determined according to the International Classification of Periodontal Diseases in 1999. The patients in G-AgP group (n=20) had a minimum three teeth apart from the first molars and incisors showing CAL ≥5 mm and PPD ≥6 mm. Radiographic bone loss was ≥30 % of root length affecting ≥3 teeth other than first molars and incisors. This generalized pattern of severe destruction was inconsistent with the amount of microbial deposits. Patients had at least one other family member presenting with or having a history of severe periodontal problems. Periodontally healthy individuals (n=20) in the control group had no sites with PPD >3 mm and CAL >2 mm and also no radiographic evidence of alveolar bone loss. BOP was <15% in the whole mouth.


The recruited G-AgP patients received conventional quadrant scaling and root planning (SRP) under local anaesthesia for 3 weeks. SRP was performed by the same periodontist (who was different the investigator recorded periodontal parameters) using ultrasonic inserts and manual periodontal curettes. Re-evaluations were performed at 1 and 3 months following the completion of the SRP in the lower right quadrant. No periodontal intervention was carried out in the periodontally healthy controls.

GCF sampling

GCF was sampled from two deepest pockets of single-rooted teeth at baseline in G-AgP group immediately before the treatment of upper right quadrant. Sampling was repeated at the same sites following the completion of the SRP in the lower right quadrant. GCF was sampled from the buccal aspects of two nonadjacent interproximal sites in single-rooted teeth with. Samples were collected from the sites without BOP in the periodontally healthy group. Standardized filter paper strips were used for GCF sampling. Sterile paper strips were gently inserted into the gingival sulcus or pocket until mild resistance was felt and left there for 30 s. The absorbed fluid volume was measured with a precalibrated electronic device. The paper strips were stored at −40◦C for further analysis.

Measurement of HIF-1α, VEGF and TNF-α Levels in GCF

Two paper strips were pooled, placed in 300 µL PBS-T (0.05%). HIF-1α, VEGF and TNF-α levels in GCF samples were measured by the enzyme-linked immunosorbent assay using commercial kits in line with the manufacturer's guidelines. GCF results were expressed as both total amounts at two sites per sampling time.

Statistical Analysis

All statistical analyses were carried out with the standard statistical software package. For the intra-group comparisons, if the data were not normally disturbed, Friedman test and the Dunn test with the Bonferroni correction were used to analyze the change between baseline and 1 month and 3 months after treatment. For inter-group comparisons, Mann-Whitney U test for normally and non-normally disturbed data. The Spearman's rank correlation test was used to detect the correlations of biochemical parameters with clinical parameters and each others in diseased group before and after treatment. All tests were performed at significance level of P <0.05.

Study Design


Aggressive Periodontitis, Generalized


Non-surgically performed scaling and root planing


Adnan Menderes University, Faculty of Dentistry, Department of Periodontology




Aydin Adnan Menderes University

Results (where available)

View Results


Published on BioPortfolio: 2019-07-19T10:43:34-0400

Clinical Trials [1129 Associated Clinical Trials listed on BioPortfolio]

Study of Scaling and Root Planing With PerioWave Versus Scaling and Root Planing Alone in Chronic Periodontitis

This study is to determine whether scaling and root planing (SRP) followed by photodynamic disinfection results in improved outcomes that persist over time in adults with chronic periodont...

Serum TRAP-5b Levels in Patients With Generalized Chronic Periodontitis

To compare the effect of non-surgical periodontal therapy with or without systemic administration of amoxicillin and metronidazole on the concentration of serum levels of TRAP-5b in patien...

Study of Scaling and Root Planing (SRP) With PerioWave vs. SRP Alone in Chronic Periodontitis

This study is to determine whether scaling and root planning (SRP) followed by photodynamic disinfection results in improved outcomes that persist over time in adults with chronic periodon...

Diode Laser Therapy As An Adjunct To Scaling And Root Planing

Laser therapy has been proposed as a novel treatment option in controlling subgingival microorganisms. This randomized controlled clinical trial evaluates the effect of 980nm diode laser a...

Adjunctive Use of Salvadora Persica in Chronic Periodontitis

A randomized controlled triple blinded study to evaluate the effectiveness of Salvadora Persic (SP) as an adjunct to Scaling and Root Planing (SRP) in chronic periodontitis by comparing th...

PubMed Articles [9034 Associated PubMed Articles listed on BioPortfolio]

Effect of photobiomodulation therapy as an adjunct to scaling and root planing in a rat model of ligature-induced periodontitis: a histological and radiographic study.

This study aimed to histologically and radiographically evaluate the effectiveness of low-intensity laser irradiation of different wavelengths (660 or 808 nm) as an adjunct to scaling and root planin...

Treatment of experimental periodontitis with chlorhexidine as adjuvant to scaling and root planing.

To assess whether subgingival irrigation with 0.12 % or 0.2 % chlorhexidine (CHX) immediately after scaling and root planing (SRP) enhances periodontal tissue repair compared to irrigation with saline...

Clinical Effectiveness Of Indocyanine Green Mediated Antimicrobial Photodynamic Therapy As An Adjunct To Scaling Root Planning In Treatment Of Chronic Periodontitis- A Randomized Controlled Clinical Trial.

Antimicrobial photodynamic therapy (aPDT) along with scaling and root planing has been studied for treatment of periodontitis. Various photosensitizers have been utilized for the same. The present stu...

Effectiveness of Adjunctive Use of Low-Level Laser Therapy and Photodynamic Therapy After Scaling and Root Planing in Patients with Chronic Periodontitis.

The aim of this split-mouth, randomized controlled clinical trial was to evaluate the efficacy of low-level laser therapy (LLLT) and photodynamic therapy (PDT) as an adjunct to scaling and root planin...

Protozoans in subgingival biofilm: clinical and bacterial associated factors and impact of scaling and root planing treatment.

: In patients with periodontitis, identification of protozoans and evaluation of some bacteria and clinical parameters associated and assessment of scaling and root planing (SRP) impact on their detec...

Medical and Biotech [MESH] Definitions

A procedure for smoothing of the roughened root surface or cementum of a tooth after subgingival curettage or scaling, as part of periodontal therapy.

Removal or disruption of DENTAL DEPOSITS and plaque-retentive DENTAL CALCULUS from tooth surfaces and within the periodontal pocket space without deliberate removal of CEMENTUM as done in ROOT PLANING and often in DENTAL SCALING. The goal is to conserve dental cementum to help maintain or re-establish healthy periodontal environment and eliminate PERIODONTITIS by using light instrumentation strokes and nonsurgical techniques (e.g., ultrasonic, laser instruments).

Inflammation and loss of connective tissues supporting or surrounding the teeth. This may involve any part of the PERIODONTIUM. Periodontitis is currently classified by disease progression (CHRONIC PERIODONTITIS; AGGRESSIVE PERIODONTITIS) instead of age of onset. (From 1999 International Workshop for a Classification of Periodontal Diseases and Conditions, American Academy of Periodontology)

Inflammation and loss of PERIODONTIUM that is characterized by rapid attachment loss and bone destruction in the presence of little local factors such as DENTAL PLAQUE and DENTAL CALCULUS. This highly destructive form of periodontitis often occurs in young people and was called early-onset periodontitis, but this disease also appears in old people.

Designation for several severe forms of ichthyosis, present at birth, that are characterized by hyperkeratotic scaling. Infants may be born encased in a collodion membrane which begins shedding within 24 hours. This is followed in about two weeks by persistent generalized scaling. The forms include bullous (HYPERKERATOSIS, EPIDERMOLYTIC), non-bullous (ICHTHYOSIS, LAMELLAR), wet type, and dry type.

More From BioPortfolio on "GCF HIF-1α, VEGF and TNF-α Levels in G-AgP Patients Before and After Periodontal Treatment."

Quick Search

Relevant Topics

Cytokine Tumour Necrosis Factor (TNF)
TNF is a compound that is classified as a cytokine which plays a central role in the cellular mechanisms of apoptosis or cell death. However, there are a number of different kinds of TNF, just under twenty, but the family of molecules have very similar a...

Biological Therapy
Biological therapy involves the use of living organisms, substances derived from living organisms, or laboratory-produced versions of such substances to treat disease. Some biological therapies for cancer use vaccines or bacteria to stimulate the body&rs...

Searches Linking to this Trial