TUMOR NECROSIS FACTOR-ALPHA IN GINGIVAL CREVICULAR FLUID AS A DIAGNOSTIC MARKER FOR PERIODONTAL DISEASES: A SYSTEMATIC REVIEW

Objectives The aim of this systematic review was to evaluate human gingival crevicular fluid (GCF) tumor necrosis factor-alpha (TNF-alpha) as a potential biomarker for diagnosis of periodontal disease (International prospective register of systematic reviews [PROSPERO] number: CRD42015020199). Methods An electronic search for TNF-alpha in human GCF was conducted until May 17, 2018. Data from systemically healthy patients with healthy periodontium or periodontal disease were incorporated. Risk bias was assessed by Newcastle-Ottawa Scale for case-control studies and Jadad scale for clinical trials. Results Twenty-six studies were included (12 case-control studies, 7 clinical trials, and 7 randomized controlled trials). Most case-control studies showed increased TNF-alpha concentration in GCF of patients with periodontal disease. The clinical trials and randomized controlled trials demonstrated no consistent modification of TNF-alpha level after periodontal intervention. Conclusion The present data support the use of TNF-alpha in GCF as a potential biomarker for diagnosis of periodontal disease but not to monitor the healing after therapy.