TNF and periodontitis: Furthermore, T2DM is considered a significant risk factor for the development of periodontitis (Dhir et al., 2018), because T2DM intensifies the inflammatory response in periodontal tissues, significantly increasing the levels of proinflammatory mediators such as IL-1β and TNF-α, as well as an increase in the activity of matrix metalloproteinases (MMP) (Mesia et al., 2016).