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Gingival crevicular fluid levels of interleukin-18 and tumor necrosis factor-alpha in type 1 diabetic children with gingivitis

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This study aimed to evaluate the levels of interleukin-18 and tumor necrosis factor-alpha in gingival crevicular fluid of diabetic children with gingivitis.


Eighty-eight children (44 with type 1 diabetes mellitus and 44 systemically healthy) were recruited for the study. The children were divided into four subgroups based on their periodontal and systemic condition: (1) systemically and periodontally healthy children (H), (2) systemically healthy children with gingivitis (G), (3) periodontally healthy children with T1DM (T1DM + H), and (4) children with T1DM and gingivitis (T1DM + G). The plaque index, gingival index, probing pocket depth, and GCF volume were recorded. The IL-18 and TNF-α levels in GCF were determined by ELISA.


The clinical periodontal parameters, GCF IL-18 level, and TNF-α level were similar between diabetic and systemically healthy children (p > 0.05). The gingivitis subgroups had a significantly higher GI, PI, PPD, GCF volume, and TNF-α total amounts than the H subgroups (p < 0.0001). The IL-18 concentrations in the gingivitis subgroups were significantly lower than in the periodontally healthy subgroups.


In diabetic children with good metabolic control, T1DM did not affect the GCF levels of IL-18 and TNF-α in the presence of gingivitis. However, increased GCF TNF-α levels in children with gingivitis confirm that TNF-α is closely related to gingival inflammation.

Clinical relevance

Type 1 diabetes mellitus is not associated with GCF interleukin-18 and tumor necrosis factor-alpha levels in children with gingivitis.

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Author information

Sultan Keles and Ahmet Anik conceived the ideas; Sultan Keles and Ahmet Anik collected the data; SK., OC, BIA, and Ayse ANİK analyzed the data; and SK led the writing.

Correspondence to Sultan Keles.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Adnan Menderes University Faculty of Dentistry Clinical Investigations Ethics Committee.

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Informed consent was obtained from all of the individual participants and their parents/caregivers included in the present study.

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Keles, S., Anik, A., Cevik, O. et al. Gingival crevicular fluid levels of interleukin-18 and tumor necrosis factor-alpha in type 1 diabetic children with gingivitis. Clin Oral Invest (2020). https://doi.org/10.1007/s00784-020-03238-z

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  • Gingival crevicular fluid
  • Gingivitis
  • Diabetes mellitus