title: Estimation of salivary tumor necrosis factor-alpha in chronic and aggressive periodontitis patients.
abstract: BACKGROUND
  Periodontitis is a chronic bacterial infection characterized by persistent inflammation, connective tissue breakdown and alveolar bone destruction mediated by pro-inflammatory mediators. Tumor necrosis factor-alpha (TNF-α) is an important pro-inflammatory mediator that produced causes destruction of periodontal tissues.
  
  
  OBJECTIVE
  The aim of the study is to estimate the salivary TNF-α in chronic and aggressive periodontitis and control participants and further correlate the levels with clinical parameter such as gingival index (GI), plaque index (PI), probing pocket depth (PPD) and clinical attachment loss.
  
  
  METHODS
  The study population consisted of 75 subjects age ranging from 25 to 55 years attending the outpatient section of Department of Periodontics, Saveetha Dental College and Hospital. The study groups included Groups 1, 2, and 3 with participants with healthy periodontium (n = 25), generalized chronic periodontitis (n = 25) and generalized aggressive periodontitis (n = 25), respectively. Salivary samples from the participants were used to assess the TNF-α levels using enzyme-linked immunosorbent assay.
  
  
  RESULTS
  GI and PI were found to be significantly higher in chronic and aggressive periodontitis compared to the controls. The mean TNF-α value in chronic periodontitis patients (12.92 ± 17.21 pg/ml) was significantly higher than in control subjects (2.15 ± 3.60 pg/ml). Whereas, in aggressive periodontitis patients the mean TNF-α (7.23 ± 7.67) were not significantly different from chronic periodontitis or healthy subjects. Among periodontitis participants, aggressive periodontitis subjects exhibited a significant positive correlation between the salivary TNF-α and PPD.
  
  
  CONCLUSIONS
  Salivary TNF-α levels are significantly higher in chronic periodontitis than in healthy subjects, but there was no significant correlation with the clinical parameters.
authors.affiliation: Department of Periodontology, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Sheeja S
authors.initials: SS
authors.lastname: Varghese
authors.affiliation: Department of Periodontology, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Hima
authors.initials: H
authors.lastname: Thomas
authors.affiliation: Department of Periodontology, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: N D
authors.initials: ND
authors.lastname: Jayakumar
authors.affiliation: Department of Periodontology, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: M
authors.initials: M
authors.lastname: Sankari
authors.affiliation: Department of Periodontology, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India.
authors.forename: Reema
authors.initials: R
authors.lastname: Lakshmanan
keywords: Aggressive periodontitis; chronic periodontitis; cytokines; tumor necrosis factor-alpha