Shoukheba and Elkholy also showed that RSV significantly decreased BOP scores from baseline to 6 months.54The improvement in bleeding of the gingiva may be related to the anti-inflammatory effect of RSV that inhibits the expression of proinflammatory cytokines, such as IL-1 and tumor necrosis factor-α, which are involved in the pathogenesis of periodontitis.55 This evidence concerns the gene TNF and periodontitis.