Effectiveness of Injectable Platelet-rich Fibrin on Interleukin-6 Levels in Chronic Periodontitis with Type II Diabetes: A Randomized Controlled Trial

RESEARCHtumor necrosis factor-α (TNF-α), which are produced by activated macrophages and involved in inflammatory reactions.The antiinflammatory cytokines are the series of immunomodulatory molecules that control proinflammatory cytokines response.IL-6 and IL-8 are the important inflammatory cytokines that are responsible for the initiation of periodontal disease. 5 IntroductIonPeriodontal diseases are the second most common oral disease, preceded by dental caries.They include gingivitis, where the inflammation is confined to the gingiva only, and periodontitis, which is the extension of inflammation to tissues and alveolar bone. 1 Periodontitis is a chronic inflammatory multifactorial disease that causes progressive destruction to supporting periodontal tissues.Among various etiological factors, dental plaque is the most common etiological factor. 2 The severity of periodontal disease depends upon the interactions between periodontopathogens and host immune inf lammator y response.Various virulence factors, like lipopolysaccharides from periodontal microbes, trigger inflammatory cytokine expression. 3ytokines are small polypeptides produced by various cells, such as monocytes/macrophages, dendritic cells, lymphocytes, neutrophils, endothelial cells, and fibroblasts. 3The term cytokine has been used to refer to immunomodulating agents such as interleukins and interferons. 4They are classified into proinflammatory cytokines and anti-inflammatory cytokines.The proinflammatory cytokines are interleukin-1ß (IL-1ß), IL-6, IL-8, and