_applied_  
_sciences_  
_Article_  
**Influence of Ceramic Luminescence on Inflammatory Periodontal Parameters and Gingival Circular Fluid IL-6 and TNF-\(\alpha\) Levels--A Clinical Trial**  
**[PERSON] 1\({}^{\copyright}\), [PERSON] 2, [PERSON] 2, [PERSON] 2, [PERSON] 3, [PERSON] 4, [PERSON] 5, [PERSON] 6, [PERSON] 7\({}^{\copyright}\) and [PERSON] 8,*\({}^{\copyright}\)\({}^{\copyright}\)**  
Footnote 1  
various studies have measured and observed the effect of different restorative materials on gingival and periodontal health [3]. In recent years, demands for esthetic restorations have increased spectacularly due to growing awareness in society. With the introduction of lumineers, there has been a revolutionary change in the field of esthetic dentistry [4]. Lumineers are considered as the most conservative indirect restorations among all minimally invasive treatments. They are custom made thin section of porcelain bonded with a permanent adhesive to the tooth surface. Lumineers are different from conventional dental veneers because of their ultrathin thickness [5; 6]. A study conducted by [PERSON] et al., displayed 93.5% survival rate of porcelain laminate veneers over a period of 10 years [7]. Though being minimally invasive, lumineers may cause periodontal problems due to over contouring and subgingival margin placement. Furthermore, lumineers are over contoured restorations as little or no tooth preparation is performed before their placement. This may also contribute to compromised periodontal health due to plaque accumulation around the restoration margins [8]. [PERSON] et al., in his five-year follow up study reported that porcelain veneers increase plaque retention [9]. Dental restorations are in close contact with the oral tissues but rarely cause systemic side effects [10]. However, local inflammatory reaction or hypersensitivity may occur in response to these restorations [11]. It is reported in previous studies that organic as well as degradation products of restorative materials are responsible for inflammatory changes in the periodontium [12; 13]. Periodontal inflammation is characterized by well-orchestrated process of host defense through leukocyte recruitment and monocyte activation. This releases pro-inflammatory mediators and cytokines (IL-1, IL-6, and Tumor necrosis factor-alpha (TNF-\(\alpha\)) in gingival crevicular fluid (GCF). TNF-\(\alpha\) is responsible for activation of certain cytokines and initiates the process of inflammation. Similarly, Interleukin-6 (IL-6) also activates localized immune cells and causes gingivitis and periodontal tissues destruction [14]. Recent studies have validated the role of salivary and serum cytokines (biomarkers) including, IL-6, transforming growth factor beta (TGF-\(\beta\)1) and vascular endothelial growth factor (VEGF) showing correlation with periodontal disease initiation and progression [15; 16]. In a study by [PERSON] et al., levels of salivary IL-6 were reported to be a valid predictor for gingival health, with periodontitis patients showing significantly higher salivary and serum IL-6 levels [17]. Concerning periodontal response towards lumineer treatment, multiple clinical studies reported good or no change in periodontal health status after ceramic veneer placement [18; 19]. By contrast, few studies displayed increased periodontal inflammation with alteration of periodontal parameters i.e., PI, BOP, and PPD [9]. In addition, there is a dearth of evidence on the periodontal clinical response (gingival health) and pro-inflammatory biomarker levels in the GCF of patients treated with adhesive lumineers. The null hypothesis of the present study was, that periodontal parameters, GCF volume, and GCF cytokine (IL-6 and TNF-\(\alpha\)) levels in patients treated with lumineers would be comparable before and after treatment.