Vascular Endothelial Growth Factor Estimation Before and After Various Treatment Modalities in Patients with Periodontal Disease (Clinical and Immunological Study)
Background: Periodontal diseases are the most common inflammatory oral conditions that affects the periodontium following dental caries, and may ultimately lead to tooth loss if left untreated. With recent advancement in the field of periodontics, application of adjunct methods and/or devices have been advocated to further improve healing in periodontally affected teeth. Vascular endothelial growth factor (VEGF) is considered the most potent angiogenic factor that is associated with both health and disease, many studies have researched the upregulation of vascular endothelial growth factor in association with wound healing and tumor growth. This study focuses on the expression levels of vascular endothelial growth factor within gingival crevicular fluid (GCF) before and after treatment. Materials and methods: A clinical trial was conducted on 30 subjects with periodontitis (16 male and 14 female). Subjects participating in the clinical trial were divided into three groups, each group including 10 individuals. 1st group were treated by scaling and root planing (SRP), 2nd group were treated by scaling and root planing with adjunct chlorhexidine, and 3rd group were treated by scaling and root planing with adjunct laser irradiation. Clinical periodontal parameters were obtained at baseline and post-treatment to assess improvement in periodontal health status clinically, parameters included were plaque index (PlI) and gingival index (GI). Gingival crevicular fluid samples were collected from each subject using filter paper strips inserted deep inside periodontal pocket for 30 seconds, collection was carried out before treatment on the 2nd visit and after treatment on 3rd visit with 2-weeks interval between visits. Concentration of vascular endothelial growth factor within collected gingival crevicular fluid samples was analyzed via the use of enzyme-linked immunosorbent assay (ELISA). Results: Improvement in clinical parameters were recorded following treatment for all subjects, the mean of vascular endothelial growth factor concentration was decreased after treatment in all subject with two of the study groups having statistically significant decrease in concentration following treatment. Conclusion: Results from this study indicate that all study groups showed clinical improvement in periodontal parameters, and decrease in VEGF conc. following treatment and no clear-cut advantage could be established between the three different treatment modalities.