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These mediators comprise interleukin-1 (IL-1), tumor necrosis factor- (TNF-), which shoulder vital responsibility in inflammatory responses ( IL-1, TNF-, and other inflammatory mediators regulate the expression in a variety of cell types like alveolar bone osteoblasts, gingival fibroblasts, amplifying the damage of periodontal tissues and bone resorption processes ( 2.3.2 Cellular dysfunction and apoptosis In gingival tissues, oxidative stress causes lipid peroxidation, protein oxidation, and DNA damage