Citation Information :
Saraswathi IR, Sadasivan A, Koshi E, Vijayakumar S, Vallabhan CG, Vrinda SM. Effect of Nonsurgical Periodontal Therapy on Serum Level of Interleukin-6 and Tumor Necrosis Factor-α in Chronic Periodontitis Patients with and without Hypothyroidism. J Contemp Dent Pract 2020; 21 (4):410-415.
Aim: The aim of this article was to determine the effect of nonsurgical periodontal therapy on clinical parameters and also to evaluate serum level of interleukin (IL)-6 and tumor necrosis factor (TNF)-α in chronic periodontitis patients with and without hypothyroidism. Materials and methods: Subjects were 40 female patients (20 systemically healthy subjects with chronic periodontitis and 20 subjects with hypothyroidism and chronic periodontitis). Clinical parameters like plaque score, gingival score, gingival recession, probing pocket depth, and clinical attachment level were recorded at baseline and 4 weeks after nonsurgical periodontal therapy. Nonsurgical periodontal therapy included oral hygiene instructions and full-mouth scaling and root planing. A total of 5 mL of venous blood sample was collected from each subject at baseline and 4 weeks after nonsurgical periodontal therapy. Results: The clinical parameters and biochemical parameters like IL-6 and TNF-α in both groups showed pronounced reduction at the end of 4 weeks following nonsurgical periodontal therapy. However, simultaneous comparison of clinical and biochemical parameters between the two groups was not statistically significant. Conclusion: This study provides evidence that nonsurgical periodontal therapy contribute to reduction in serum level of IL-6 and TNF-α in systemically healthy subjects with chronic periodontitis and subjects with hypothyroidism and chronic periodontitis. Clinical significance: The prevalence of periodontitis as well as hypothyroidism is increasing nowadays. Interleukin-6 and TNF-α are found to play a significant role in pathobiology of both periodontitis and hypothyroidism. With the treatment of periodontitis, it is found that there is improvement in periodontal and thyroid status of the patients. So, it is an alert to health professionals about the relation of hypothyroidism and periodontitis so that they consider a multidisciplinary approach.
Gaspersic R, Stiblar-Martincic D, Osredkar J, et al. Influence of subcutaneous administration of recombinant TNF-α on ligatureinduced periodontitis in rats. J Periodontal Res 2003;38(2):198–203. DOI: 10.1034/j.1600-0765.2003.01395.x.
Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. New England J Med 2001;344(7):501–509. DOI: 10.1056/NEJM200102153440707.
Akalin A, Colak O, Alatas O, et al. Bone remodelling markers and serum cytokines in patients with hyperthyroidism. Clin Endocrinol (Oxf) 2002;57(1):125–129. DOI: 10.1046/j.1365-2265.2002.01578.x.
Al-Rubbaey YA. Oral health status and dental treatment needs in relation to salivary constituents and parameters among a group of patients with thyroid dysfunction. J Baghdad Colle Dent 2010;22(1):105–108.
Hodkinson CF, Simpson EE, Beattie JH, et al. Preliminary evidence of immune function modulation by thyroid hormones in healthy men and women aged 55-70 years. J Endocrinol 2009;202(1):55. DOI: 10.1677/JOE-08-0488.
Liu YC, Lerner UH, Teng YT. Cytokine responses against periodontal infection: protective and destructive roles. Periodontol 2000 2010;52(1):163–206. DOI: 10.1111/j.1600-0757.2009.00321.x.
Sekeroglu MR, Altun ZB, Algün E, et al. Serum cytokines and bone metabolism in patients with thyroid dysfunction. Adv Ther 2006;23(3):475–480. DOI: 10.1007/bf02850169.
McGee JM, Tucci MA, Edmundson TP, et al. The relationship between concentrations of proinflammatory cytokines within gingiva and the adjacent sulcular depth. J Periodontol 1998;69(8):865–871. DOI: 10.1902/jop.19220.127.116.115.
Kanatani M, Sugimoto T, Sowa H, et al. Thyroid hormone stimulates osteoclast differentiation by a mechanism independent of RANKL–RANK interaction. J Cell Physiol 2004;201(1):17–25. DOI: 10.1002/jcp.20041.
Vestergaard P, Mosekilde L. Fractures in patients with hyperthyroidism and hypothyroidism: a nationwide follow-up study in 16,249 patients. Thyroid 2002;12(5):411–419. DOI: 10.1089/105072502760043503.
Aziz AS, Kalekar MG, Benjamin T, et al. Effect of nonsurgical periodontal therapy on some oxidative stress markers in patients with chronic periodontitis: a biochemical study. World J Dent 2013;4(1):17–23. DOI: 10.5005/jp-journals-10015-1196.
Unnikrishnan AG, Menon UV. Thyroid disorders in India: an epidemiological perspective. Indian J Endocrinol Metab 2011;15(2):S78. DOI: 10.4103/2230-8210.83329.
Baskin HJ, Cobin RH, Duick DS, et al. American association of clinical endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism: AACE thyroid task force. Endocrine practice 2002;8(6):457–469. DOI: 10.4158/1934-2403-8.6.457.
Kim J, Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology 2006;94(1):10–21. DOI: 10.1007/s10266-006-0060-6.
Aimetti M, Romano F, Nessi F. Microbiologic analysis of periodontal pockets and carotid atheromatous plaques in advanced chronic periodontitis patients. J Periodontol 2007;78(9):1718–1723. DOI: 10.1902/jop.2007.060473.
Creasey AA, Stevens P, Kenney J, et al. Endotoxin and cytokine profile in plasma of baboons challenged with lethal and sublethal Echerichia coli. Circ Shock 1991;33(2):84–91.
Fenkci S, Corapcioglu D, Erdogan G. The effects of thyrotoxicosis on serum IL-6 and bone turnover in premenopausal women. Turkish J Endocrinol Metabolism 2001;3:97–101.
Babu NV, Patel PB. Oral health status of children suffering from thyroid disorders. J Indian Soc Pedodont Prevent Dent 2016;34(2):139. DOI: 10.4103/0970-4388.180443.
Hanau KJ, Razzoqi Naoom E, Mahammed HO. CPITN in Iraqi females with thyroid dysfunction. Mustansir Dent J 2018;9(1):99–106.
Kothiwale S, Panjwani V. Impact of thyroid hormone dysfunction on periodontal disease. J Scienti Soc 2016;43(1):34. DOI: 10.4103/0974-5009.175456.
Jirik FR, Podor TJ, Hirano T, et al. Bacterial lipopolysaccharide and inflammatory mediators augment IL-6 secretion by human endothelial cells. J Immunol 1989;142(1):144–147.
Bonavida B, Paubert-Braquet M, Hosford D, et al. The involvement of platelet-activating factor (PAF)-induced monocyte activation and tumor necrosis factor (TNF) production in shock. Prog Clin Biol Res 1989;308:485–489.
Monea A, Elod N, Sitaru A, et al. Can thyroid dysfunction induce periodontal disease? Euro Scienti J 2014;10(15):1857–7431.
Goutoudi P, Diza E, Arvanitidou M. Effect of periodontal therapy on crevicular fluid interleukin-6 and interleukin-8 levels in chronic periodontitis. Int J Dent 2012;2012 10.1155/2012/362905.
D’Aiuto F, Parkar M, Andreou G, et al. Periodontitis and systemic inflammation: control of the local infection is associated with a reduction in serum inflammatory markers. J Dent Res 2004;83(2): 156–160. DOI: 10.1177/154405910408300214.
Pawlowski AP, Chen A, Hacker BM, et al. Clinical effects of scaling and root planing on untreated teeth. J Clin Periodontol 2005;32(1):21–28. DOI: 10.1111/j.1600-051X.2004.00626.x.
Klein JR, Maywood NJ. The immune system as a regulator of thyroid hormone activity. Exp Biol Med 2006;231(3):229–236. DOI: 10.1177/153537020623100301.
Borgnakke WS, Ylostalo PV, Taylor GW, et al. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Periodontol 2013;84(4):S135–S152. DOI: 10.1902/jop.2013.1340013.
Silverston SF. Endocrine disease. In: Greenberg MS, Glick M. Burket’s Oral Medicine diagnosis and treatment. 10th ed., Hamilton, Ontario: BC Decker Inc; 2003. pp. 578–591.
Simpson TC, Needleman I, Wid SH, et al. Cochrane Database Syst Rev 2010(5):CD004714. DOI: 10.1002/14651858.CD004714.pub2.