| Objectives:To observe the influence of subgingival scaling on the expressions of melatonin, tumor necrosis factor-a and interleukin-1β among patients with periodontitis, and to explore the possible role of melatonin in the progression of periodontitis via further analysis of clinical characteristics.Methods:27 patients with periodontitis were selected according to Armitage’s diagnostic standard, and 18 healthy subjects were recruited as healthy controls.Patients’medical history and oral panoramic radiographs were collected, and target teeth were determined by detailed periodontal examinations. Then, supragingival scaling was performed during the first visit, followed by subgingival scaling one week later. Recalls were required in 4 weeks. Before subgingival scaling, patients’informations and periodontal examinations were recorded as baseline, and blood, saliva and GCF of target teeth were collected as well. Meanwhile, blood and saliva were collected from the healthy controls. Sample collections and periodontal examinations were repeated in the recall visit. MT, TNF-a and IL-1β were detected using enzyme-linked immunosorbent assay. Rank sum test was used to compare their differences in periodontitis patients and healthy controls, as well as differences of MT, TNF-a, IL-1βlevels pre-and post-treatment in periodontitis patients. Spearman rank test was used for analysis of correlation between MT, TNF-a, IL-1β and clinical characteristics including PD, CAL, BOP.Results:1. The level of serum MT of periodontitis patients pre-treatment was lower than post-treatment (Z=-2.186, P=0.029,and also both were lower than that of healthy controls (P< 0.001). No statistical difference was found between levels of salivary MT among healthy controls and periodontitis patients both pre-and post-treatment (P>0.05), but the level of MT in GCF of periodontitis patients pre-treatment was higher than post-treatment (Z=-2.667, P<0.001).2. There were no significant correlation among MT levels of blood, saliva and GCF in periodontitis patients pre-treatment. There was no significant correlation between MT levels of blood and saliva in healthy controls.3. Relationship among levels of IL-1β, TNF-a and periodontal parameters in periodontitis patients pre-treatment:No significant correlation was found between salivary IL-1β, TNF-a and periodontal parameters; IL-1β was positively correlated with sample tooth PD in GCF (r= 0.350, P= 0.041), and was positively correlated with BOP of target teeth (r= 0.514, P= 0.011), TNF-a was positively correlated with PD of target teeth in GCF (r=0.304, P=0.045), and was positively correlated with BOP of target teeth (r=0.427, P=0.036) 4. Relationship among MT and periodontal parameters in periodontitis patients pre-treatment:Serum MT was negatively correlated with PD of whole oral cavity (r=-0.465, P=0.034) and BOP index (r=-0.466, P=0.025), but no significant correlation was found between serum MT and CAL of whole oral cavity. Meanwhile, salivary MT was negatively correlated with BOP index of the whole oral cavity (r=-0.401, P=0.021) and MT of GCF was positively correlated with PD of target teeth (r=0.465, P=0.045).5. Relationship between MT and IL-1β, TNF-a in periodontitis patients pre-treatment:No significant correlation was found among salivary MT and IL-1β, TNF-a; MT was positively correlated with IL-1β(r=0.442, P=0.015) in GCF.6. Logistic regression analysis showed that OR between serum melatonin level and periodontitis was 0.756 (B=-0.280, P=0.030,95%CI of OR:0.587-0.974), indicating that high level of MT in blood was a protective factor for periodontitis.Conclusion:1. MT level in GCF was positively correlated with both IL-1β level and PD of target teeth in patients with periodontitis which specifies us about its positive relation to severity of periodontal disease.2. There was a low expression of MT level in blood of patients with periodontitis. The upregulated MT expression in GCF might be induced locally by gingival inflammation. |
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