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Evaluation of Level of TNF-α in Chronic Periodontitis Patients with Gestational Diabetes Mellitus after Phase I Periodontal Therapy

Omneya M. Elkadi*, Gihane Gharib Madkour, Hala Salem Elmenoufy and Mahmoud El Refai

Background: There is little number of studies that address the inter-relationship of gestational diabetes mellitus (GDM) and periodontitis during pregnancy. Hence, this study was conducted to provide further evidence in the possible association between chronic periodontitis and GDM by evaluating the level of Tumor necrosis factor-alpha (TNF-α) of chronic periodontitis patients with GDM after phase I periodontal therapy.
Subjects and methods: This study was conducted on 40 subjects divided into 2 groups: 20 pregnant females suffering from gestational diabetes mellitus associated with moderate to severe chronic periodontitis and 20 systemically free pregnant females suffering from moderate to severe chronic periodontitis. The periodontal status of the subjects was assessed at baseline before phase I periodontal therapy and 2 months after completion of the treatment: All subjects have been screened by comprehensive periodontal examination and full periodontal charts were obtained. The following clinical parameters were assessed to determine the clinical periodontal status of patients: Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL). Gingival crevicular fluid (GCF) and serum samples were collected from both study groups to detect TNF-α levels. Regarding the assessment of TNF-α, Real-time reverse-transcriptase Polymerase Chain Reaction (RT) PCR technique was used.
Results: Results of the present study observed statistically significant reduction in TNF-α levels after 2 months from phase I periodontal therapy. The current study showed that, there was a statistically significant positive (direct) correlation between TNF-α level, PI, GI, PPD and CAL measurement at baseline and after 2 months from phase I periodontal therapy.
Conclusion: It is shown that the levels of TNF-α in GCF and serum before treatment were higher in GDM group (group 1) than in the control group. Thus, the examination of TNF-α may enhance the understanding of pathogenesis of periodontitis and GDM and its assessment in the treatment process may result in better control of the disease.