Tumor Necrosis Factor-alpha in Gingival Crevicular Fluid as a Diagnostic Marker for Periodontal Diseases: A Systematic Review

The aim of this systematic review was to evaluate human gingival crevicular fluid (GCF) tumor necrosis factor-alpha (TNF-α) as a potential biomarker for diagnosis of periodontal disease (International prospective register of systematic reviews [PROSPERO] number: CRD42015020199). An electronic search for TNF-α 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. Twenty-six studies were included (12 case-control studies, 7 clinical trials, and 7 randomized controlled trials). Most case-control studies showed increased TNF-α concentration in GCF of patients with periodontal disease. The clinical trials and randomized controlled trials demonstrated no consistent modification of TNF-α level after periodontal intervention. The present data support the use of TNF-α in GCF as a potential biomarker for diagnosis of periodontal disease but not to monitor the healing after therapy.