## 3 Results
### Periodontal Profile in the Study Groups
Taking into consideration the periodontitis staging as well, the refined statistical analysis revealed significant differences between groups as follows: for DM, in stage 1 (\(p\) = 0.016) and stage 3-4 (\(p\) = 0.002); for GR, in stage 2 (\(p\) = 0.002) and stage 3 (\(p\) = 0.000); for PPD and CAL, only in stage 3-4 (\(p\) = 0.002 and \(p\) = 0.000, respectively). Local Oral Expression of TNF-\(\alpha\), IL-1\(\beta\) and MMP-8 Inflammatory Biomarkers in Gingful Fluid  
The representative values of inflammatory biomarkers for each patient are compiled in Table 4, for both the subjects with systemic and periodontal alteration (group 1) and the control group, without systemic alteration. Furthermore, Table 5 summarizes biomarker values according to periodontitis staging. In group 1, TNF-\(\alpha\) recorded levels ranging between 0.90 pg/mL and 35.90 pg/mL, with an average of 22.85 \(\pm\) 5.87 pg/mL. Cytokine IL-1\(\beta\) values varied between 6.60 pg/mL and 201.30 pg/mL, with an average of 33.00 \(\pm\) 39.68 pg/mL. Nevertheless, the MMP-8 values in the double affected subjects recorded levels as low as 5.60 ng/mL and highest 121.50 ng/mL, with an average of 18.80 \(\pm\) 27.75 ng/mL. For group 2, TNF-\(\alpha\) values varied less compared to those recorded in subjects with CKD (0.10 pg/mL and 5.50 pg/mL), with a mean of 2.10 \(\pm\) 1.34 pg/mL. The same pattern regarding downsized levels have been recorded for cytokine IL-1\(\beta\) in this study group \begin{table}
\begin{tabular}{c c c c c c c} \hline \hline \multirow{2}{*}{**Values**} & \multicolumn{2}{c}{**TNF-\(\alpha\) (pg/mL)**} & \multicolumn{2}{c}{**IL-1\(\beta\) (pg/mL)**} & \multicolumn{2}{c}{**MMP-8 (ng/mL)**} \\ \cline{2-7}  & **Group 1** & **Group 2** & **Group 1** & **Group 2** & **Group 1** & **Group 2** \\ \hline Minimum & 0.90 & 0.10 & 6.60 & 5.30 & 5.60 & 4.60 \\ \hline Mean & 22.80 & 2.10 & 33.00 & 0.71 & 18.80 & 5.35 \\ \hline Maximum & 35.90 & 5.50 & 201.30 & 60.80 & 121.50 & 6.10 \\ \hline \hline \end{tabular}
\end{table} 
Table 4: GCF immune biochemical biomarkers levels in study group versus control group. Figure 1: Comparison between periodontal parameters in group 1 vs. group 2 (DM—dental mobility, GR—gingival recession, PPD—pocket probing depth, CAL—clinical attachment loss, **—**–statistically significant difference). compared to the patients in the first lot, with rather narrow fluctuations in the interval 5.30 pg/mL and 60.80 pg/mL and an average 0.71 \(\pm\) 2.42 pg/mL, and for MMP-8 as well, the values varying between 4.60 ng/mL and 6.10 ng/mL, with an average of 5.35 \(\pm\) 0.37 ng/mL. The statistical analysis revealed significant differences between the mean values of groups as referring to both, cytokines TNF-\(\alpha\) (p \(<\) 0.000), IL-1\(\beta\) (\(p\) = 0.01) and zinc-dependent endopeptidase MMP-8 (\(p\) = 0.000) circular levels (Figure 2). Considering periodontitis staging, our results indicated statistically significant differences between groups in what concerns TNF-\(\alpha\) values in all three stages, as follows: mild (\(p\) = 0.000), moderate and severe (\(p\) < 0.000). There were no statistically significant differences between groups for IL-1\(\beta\), for any periodontitis stage. For MMP-8 the statistical analysis revealed significant differences in study group versus control group, in stage 1 (\(p\) < 0.000) and stage 3-4 (\(p\) = 0.024).