Effect of non-surgical periodontal treatment on gingival crevicular fluid hypoxia inducible factor-1 alpha, vascular endothelial growth factor and tumor necrosis factor-alpha levels in generalized aggressive periodontitis patients

Abstract

Background Hypoxia-inducible angiogenic pathway involving hypoxia inducible factor-1 alpha (HIF-1 alpha), vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF-alpha) may regulate several biological processes related to inflammation. The present study aimed to assess the effect of non-surgical periodontal treatment on gingival crevicular fluid (GCF) HIF-1 alpha, VEGF, and TNF-alpha levels in generalized aggressive periodontitis (G-AgP). Methods Twenty G-AgP patients and 20 periodontally healthy individuals were included. G-AgP patients received scaling and root planning (SRP), per quadrant at a 1-week-interval, performed with ultrasonic and periodontal hand instruments. GCF samples were collected and clinical periodontal parameters including probing depth, clinical attachment level, gingival index and plaque index were recorded at baseline, 1 and 3 months after treatment. Biomarker levels in GCF were analyzed by ELISA. Results At baseline all clinical parameters and GCF HIF-1 alpha, VEGF, and TNF-alpha levels were significantly higher in G-AgP patients compared to healthy control (P < 0.05). All clinical parameters improved over the 3-month-period in G-AgP patients (P < 0.05). GCF HIF-1 alpha levels in G-AgP reduced at 1 and 3 months post-treatment, however, this did not reach to statistical significance (P > 0.05). GCF VEGF and TNF-alpha levels remained unchanged throughout the study period (P > 0.05). Conclusions Within the limitations of the present study, although HIF-1 alpha seems to possess a potential diagnostic value for G-AgP, it might not be a proper predictor of clinically favorable treatment outcome. SRP plus different adjunctive therapies could provide better information about the prognostic role of hypoxia-inducible angiogenic pathway in G-AgP.