“…As regards to periodontal tissue destruction, proinflammatory cytokines stimulate metalloproteinases such as MMP-1, MMP-3, and MMP-13, which degrade extracellular matrix components in periodontium 31,32) . Moreover, IL-1 and TNF-α induce bone resorption by indirectly stimulating IL-6 or directly stimulating downstream effectors associated with osteoclast differentiation and activation, such as receptor activator of nuclear factor kappa B ligand (RANKL).…”