Effect of smoking on potential salivary markers of periodontal disease: A clinical and biochemical study

Introduction: Tobacco smoking exerts a harmful effect on the periodontal tissues manifested by periodontal pockets, attachment loss, and periodontal bone loss. Various factors contribute to the deleterious periodontal effects of smoking, including alteration of both microbial and host response factors. Moreover, smoking may exert effects throughout the cytokine network. Aims: The aim of this study was to evaluate the influence of smoking on periodontal biomarkers possibly related to the development of periodontitis including inflammatory mediators and pro-inflammatory cytokines in saliva. Materials and Methods: A total of sixty subjects aged 30–55 years were included in the study and divided into three groups: systemically and periodontally healthy individuals (Group 1), subjects with pocket probing depth (PPD) ≥5 mm and clinical attachment loss (CAL) of ≥2 mm (Group 2), and a subjects smoking (≥10 cigarettes a day) with periodontal parameters of Group 2 (Group 3). Periodontal parameters of PPD, CAL, gingival index (GI), and plaque index were measured using standard indices and criteria. Three milliliters of unstimulated saliva was taken, and salivary tumor necrosis factor-alpha (TNF-α) and matrix metalloproteinase-8 (MMP-8) were determined using ELISA technique. Results: The mean GI was lowest for Group 3, but the mean probing depth of Group 3 (4.93 ± 0.41) was highest. The mean TNF-α level of Group 3 was significantly different and higher as compared to Group 1 and Group 2 (24.32 ± 8.32 ng/ml vs. 6.43 ± 2.65 ng/ml, q = 16.14; P< 0.001). Similarly, the mean MMP-8 level of Group 3 (461.71 ± 58.01 ng/ml) was significantly different (P < 0.001) and higher as compared to Group 1 (192.96 ± 134.89 ng/ml) and Group 2 (347.83 ± 206.72 ng/ml). Both markers showed positive and significant correlation with their periodontal status. Conclusion: Our study clearly indicates a profound effect of smoking on salivary markers of periodontal disease (TNF-α and MMP-8) in chronic periodontitis subjects in comparison to healthy controls