Layedh et al(2021): Salivary IL-6 and TNF-α in periodonitis © Annals of Tropical Medicine & Public Health DOI: http://doi.org/10.36295/ASRO.2021.24546 317 | Page Salivary IL-6 and TNF- α in patients with periodontitis Noor Mohammed Hadi Layedh 1 ,Yamama A. Al-Rubbaey* 2 , Ali Hadi Fahad 1 , Dina A. A. Al-Roubaey 3 1. College of Dentistry, University of Kufa, Iraq 2. IbnSina University of Medical and Pharmaceutical Sciences, Iraq, Baghdad 3. College of Nursing, University of Kufa, Iraq *Corresponding author: Yamama.adnan.g@ibnsina.edu.iq (Yamama) Abstract: Background: Periodontitis is a (chronic) bacterial infection represented by connective tissue breakdown persistently, inflammation and destruction of alveolar bone interfered by pro‑inflammatory mediators. As a diagnostic non-invasive fluid; saliva could be used in diagnosis of systemic and oral diseases. The salivary biomarkers levels like cytokines could certainly be applied as an alternate to separate periodontal healthy from periodontitis subjects. Objective: Aim of the study is to evaluate the salivary (TNF-α and IL-6) in control participants and chronic periodontitis then further identify with clinical parameter levels such as the plaque index (PI), the gingival index (GI),the clinical attachment loss (CAL) and the probing pocket depth (PPD). Subjects and methods: In present study (75) patients with the age ranging from (36-65) years were registered. The sample was categorized into two main categories (25) of them were healthy (control) and other (50) have chronic periodontitis (CP). All of the attendants from the department of Periodontics of al-Shaheed Nasser al-Mosawi Specialist center in Al- Najaf city. All individuals that participate in this study were healthy and not receiving any periodontal treatment or antibiotic or anti-inflammatory remedies in the past three months prior to research. Clinical Parameters of Periodontal include Gingival Index (GI), Plaque index (PLI) , the clinical attachment level (CAL) and the probing Pocket depth(PPD). Samples of the participants’ saliva were used to assess levels of the IL-6 and TNF-α by using the enzyme-linked immunosorbent assay (ELISA). Results: There were highly significant differences among subjects suffering from periodontitis when compared to the control measured with periodontal criteria and parameters, like;(indices of plaque, Gingiva, in addition to measurement for the depth of pocket (PPD) with attachment loss (L.A)( p-value ≤0.001). The concentration of salivary interleukin-6 and tumor necrosis factor-α were highly significant for chronic periodontitis group (10.15± 3.03)(13.04±18.04), than control group (3.25±1.92) (2.32±3.72) respectively. In addition, the mean of periodontal pocket depth (3.84 ±0.19) and clinical attachment loss (2.65±0.21), were highly significant for group of chronic periodontitis when compared to the control. Conclusion: Salivary interleukin-6, with TNF-α were highly in patients with periodontitis in comparison to the control, which could be explained, as indicator might clarified the idea about the advance periodontitis. Keywords: TNF-α, Interleukin-6 , cytokine, Chronic Periodontitis DOI: http://doi.org/10.36295/ASRO.2021.24546 Page: 317-325 Volume/Issue: Volume: 24 Issue: 05 Introduction: Periodontal disease is the inflammatory disease that affect any segment of the periodontium, which includes a periodontal ligament, gingiva and an alveolar bone (1), It was divided in to major types: gingivitis and periodontitis (2;3). The gingivitis is defenders a process of the gingival tissues marginally inflammation without apparent loses of attachment to connective tissue or bone, laid by irritation of substance locally that came from accumulation of plaque ( microbial ) on the tooth surface (4). Untreated gingivitis may cause apical extension of the inflammation and result in periodontitis which is more destructive form of disease (5). Periodontitis is a bacterial chronic infection of gingiva defined by losing attachment with the jaw bone and the tooth (6). This disease also specified by breakdown of connective tissue, persistent inflammation and destruction of alveolar bone. The products of tissue breakdown and inflammatory mediators have been more often recognized in crevicular fluid of gingiva, tissues, saliva and serum of gingiva(7). Periodontitis causes increase in locally pro- inflammatory mediator of cytokines which may play a critical role in chronic inflammatory process in