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Do smokers have a different gingival crevicular fluid cytokine/chemokine profile than nonsmokers in clinically healthy periodontal sites? A systematic review and meta-analysis

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Abstract

Objectives

Assessing the evidence and comparing the levels of cytokines in gingival crevicular fluid (GCF) of periodontal healthy sites of smokers and nonsmokers.

Materials and methods

Seven databases were surveyed for observational studies up to April 8, 2021. Studies comparing cytokine levels on GCF in periodontally healthy sites of smokers vs. nonsmokers were included in the study. The risk of bias was evaluated using NIH (2014) tool. For meta-analyses, levels in GCF were analyzed, followed by evidence certainty assessment using the GRADE approach.

Results

Eighteen studies were included for qualitative evaluation, and eight were included in meta-analysis. Qualitatively, despite high heterogeneity and risk of bias observed among the studies, most of them presented no significant difference in the gingival crevicular cytokine fluid levels between groups. Regarding meta-analyses, interleukin-8 (IL-8) and superoxide dismutase (SOD) levels in GCF were analyzed. The significant difference was observed only in SOD levels, where heavy smokers had lower levels compared to nonsmokers (MD − 30.06 [− 40.17, − 19.96], p = 0.07, 95%CI), as well as light smokers had lower levels compared to nonsmokers (MD − 15.22 [− 16.05, − 14.39], p < 0.00001, 95%CI).

Conclusion

No distinct GCF cytokine profiles were detected for smokers and non-smokers. However, despite the limitations observed in the included studies, lower levels of SOD were identified in smokers.

Clinical relevance.

Indicating a distinct GCF profile of cytokines in periodontal healthy smokers may help to understand the mechanism whereby smoking may affect the host response.

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Acknowledgements

This study was funded by the São Paulo Research Foundation, grant number 2019/01522-7, and by the Latin American Oral Health Association. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES), financial code: 001. The authors thank Heloísa Maria Ceccoti (H.M.C) for her assistance in the search strategy development. The authors also would like to thank Dr. FY Bozkurt from the Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey, for providing additional information related to their articles. Their time and assistance are greatly appreciated.

Funding

This study was founded  by the São Paulo Research Foundation, grant number 2019/01522–7 and 2019/17238–6, by the Latin American Oral Health Association, and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES), financial code: 001.

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Authors and Affiliations

  1. Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil

    Tamires Pereira Dutra, Catharina Marques Sacramento, Enílson Antonio Sallum & Karina Gonzales Silverio Ruiz

  2. Department of Prosthodontics and Periodontics, Division of Prosthodontics, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil

    Bruna Egumi Nagay

  3. Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rua Prof. Rodolpho Paulo Rocco, 325, Rio de Janeiro, RJ, 21941-617, Brazil

    Marcela Baraúna Magno, Guido Artemio Marañón-Vásquez & Lucianne Cople Maia

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  1. Tamires Pereira Dutra
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  2. Catharina Marques Sacramento
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Contributions

TPD and CMS conceived and designed the study and contributed to data collection, data interpretation, and drafting, editing, and revising of the manuscript. BEN contributed to data collection, preparation of tables and figures, and drafting, editing, and revising of the manuscript. GAMV contributed to data interpretation, preparation of figures, and editing and revising of the manuscript. MBM contributed to editing and revising of the manuscript. LCM, EAS, and KGSR conceived and designed the study and contributed to data analysis, data interpretation, and drafting, editing, and revising of the manuscript. All authors approved the final version of the manuscript.

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Correspondence to Tamires Pereira Dutra.

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Dutra, T.P., Sacramento, C.M., Nagay, B.E. et al. Do smokers have a different gingival crevicular fluid cytokine/chemokine profile than nonsmokers in clinically healthy periodontal sites? A systematic review and meta-analysis. Clin Oral Invest 26, 1183–1197 (2022). https://doi.org/10.1007/s00784-021-04267-y

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