Evaluation of GCF levels of leucine-rich alpha-2 glycoprotein and TNF-α in stage III periodontitis patients: A case-control study.

BACKGROUND: Periodontitis results from interactions between oral biofilms and the host immune response, with acute-phase proteins indicating disease presence. This study measured leucine-rich alpha-2 glycoprotein (LRG) and tumor necrosis factor-alpha (TNF-α) levels before and after full-mouth disinfection. Their levels were correlated with clinical parameters. MATERIALS AND METHODS: This prospective controlled clinical study was conducted between June 2022 and June 2023 at the Department of Periodontology and Implantology, Sri Rajiv Gandhi College of Dental Sciences & Hospital, Bengaluru. Thirty systematically healthy adults (15 healthy controls and 15 with stage III periodontitis) were enrolled. Clinical parameters (PD, CAL, GI, PI, and BOP) were recorded. Gingival crevicular fluid (GCF) was collected. Periodontitis patients received full-mouth disinfection with a chlorhexidine protocol. GCF was re-sampled after six weeks. LRG and TNF-α levels were analyzed using ELISA. Spearman's rank correlation assessed associations between biomarkers and clinical parameters (p < 0.05). RESULTS: At baseline, clinical parameters and GCF levels of LRG and TNF-α were significantly higher in stage III periodontitis patients than controls. Both biomarkers correlated with indices at baseline and post-treatment. Six weeks after disinfection, PI, GI, PD, CAL, LRG, and TNF-α levels were significantly reduced (p < 0.05). Exploratory regression analysis identified significant associations between periodontal parameters and GCF biomarker levels. CONCLUSION: Patients with stage III periodontitis exhibited elevated GCF levels of LRG and TNF-α. Full-mouth disinfection significantly reduced their expression. This suggests LRG merits further study as an adjunctive marker of periodontal inflammation. The exploratory design and small sample size preclude conclusions about applicability.