The Impact of Two Cordless Retraction Materials on Inflammatory Biomarkers Interleukin-1 Beta and Tumor Necrosis Factor-Alpha in Gingival Crevicular Fluid: An In-Vivo Study.

INTRODUCTION

This study aimed to evaluate and compare the inflammatory responses of two cordless gingival retraction systems by assessing the levels of interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) in gingival crevicular fluid (GCF). The objectives were to measure IL-1β and TNF-α levels before and after retraction using kaolin-based and polyvinyl acetate-based cordless gingival retraction materials at baseline, 1 h, and 24 h, and to compare the inflammatory profiles of these materials.

MATERIALS AND METHODS

This in-vivo comparative study used a split-mouth design, with each of the 10 enrolled patients serving as their own control by receiving both kaolin-based paste (Traxodent®, Premier Dental Products, Plymouth Meeting, PA, USA) and polyvinyl acetate-based strip (Merocel®, Medtronic, Minneapolis, MN, USA) on different endodontically treated teeth requiring full-coverage crowns, thereby minimizing interindividual variability. The allocation of both agents to specific teeth was systematically determined based on clinical suitability and tooth position, alternating between the contralateral teeth to ensure consistent intraoral conditions. After oral prophylaxis and a 7-day washout period, baseline GCF samples were collected using sterile absorbent paper point (Dentsply Sirona, Charlotte, NC, USA). Traxodent®, a kaolin-based material, was applied to one tooth, and Merocel®, a polyvinyl acetate-based material, was applied to another tooth in each patient. GCF samples were collected at baseline, 1 and 24 h post-retraction, stored at -70C, and analyzed for IL-1β and TNF-α using enzyme-linked immunosorbent assay (ELISA) kits (Elabscience, New Delhi, India). Data were analyzed using independent t-tests for intergroup comparisons and repeated measures analysis of variance (ANOVA) with Bonferroni post-hoc tests for intragroup comparisons (p < 0.05).

RESULTS

Both materials significantly increased IL-1β and TNF-α levels after 1 h. The polyvinyl acetate-based strip showed sustained IL-1β elevation at 24 h, whereas the IL-1β levels of the kaolin-based paste declined. Conversely, kaolin-based paste maintained elevated TNF-α levels at 24 h, whereas the polyvinyl acetate-based strip's TNF-α level decreased significantly.

CONCLUSION

Both cordless retraction systems induced acute inflammation, with polyvinyl acetate-based strips causing prolonged IL-1β elevation and kaolin-based paste sustaining TNF-α levels. These findings suggest material-specific inflammatory responses, which can guide clinicians in selecting retraction systems to balance efficacy and periodontal health.