Salivary Tumor Necrosis Factor-alpha to detect the Severity of Erectile Dysfunction: A Randomized Clinical Trial.

AIM: This study aimed to provide evidence on the impact of chronic periodontitis (CP) on the severity of erectile dysfunction (ED) through the assessment of the salivary level of tumor necrosis factor-alpha (TNF-α). METHODS: 140 patients with chronic periodontitis and erectile dysfunction were enrolled in this study then randomly allocated to the control group (70 participants received delayed periodontal treatment) or test group (70 participants were subjected to immediate periodontal therapy). The assessment of the clinical and serological outcomes was done at baseline and 3 months postoperatively. This included pocket depth (PD), visible plaque, clinical attachment level (CAL), bleeding on probing (BOP), level of tumor necrosis factor-alpha (TNF-α), and the severity of erectile dysfunction. Periodontal therapy consists of oral hygiene instructions and single visit scaling and root planning. RESULTS: there were no significant differences regarding the serological and clinical outcomes at baseline between the two groups (p >0.05). At 3-month follow-up, the PD, BOP, CAL, and visible dental plaque means in the control group were significantly higher than those in the test group (PD: 4.94±0.647 mm vs. 4.25±0.619 mm; BOP: 49.03±29.98 vs. 6.20±7.14; CAL: 4.96±0.631 mm vs. 4.31±0.591 mm; visible dental plaque: 48.49±30.07 vs. 5.83±6.51) (p = 0.00). Compared with baseline findings, both groups showed significant reductions in TNF-α in serum, salivary TNF-α, and severity of erectile dysfunction (p < 0.001). CONCLUSION: The non-surgical periodontal therapy could significantly improve the severity of erectile dysfunction in addition to periodontal and serological parameters. Salivary TNF-α could be used as a new diagnostic tool to detect the severity of erectile dysfunction.