Levels of peri-implant sulcular fluid levels of soluble urokinase plasminogen activator receptor and TNF-α among cigarette smokers and non-smokers with peri-implantitis

Article type: Research Article

Authors: Dewan, Harisha^a | Robaian, Ali^b | Divakar, Darshan Devang^{c; d; e; *} | Hegde, Samrat Megaravalli Ramappa^f | Shankar, Shrinidhi Maji^g | Poojary, Bharathi^g

Affiliations: [a] Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia | [b] Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia | [c] Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia | [d] Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University (LMMU), Ministry of Health, Lusaka, Zambia | [e] Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India | [f] Department of Conservative and Endodontics, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India | [g] Department of Periodontics, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India

Correspondence: [*] Corresponding author: Darshan Devang Divakar, Dental Biomaterials Research Chair, Dental health Department, College of Applied Medical Sciences, King Saud University, PO Box 60169, Riyadh 11433, Saudi Arabia; and Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga NH 206, Alkola, T.H Road, Karnataka, 577204, India. E-mail: darshandevang@gmail.com.

Abstract: BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) and tumor necrosis factor-alpha (TNF-α) are inflammatory biomarkers. No studies have yet assessed the suPAR levels in relation with TNF-α in the peri-implant sulcular fluid (PISF) among cigarette smokers and non-smokers with peri-implantitis. OBJECTIVE: The aim was to evaluate PISF levels of suPAR, and TNF-α among cigarette smokers and non-smokers with and without peri-implantitis. METHODS: Sixty male patients with peri-implantitis were included. There were 20 cigarette smokers and 20 and non-smokers with peri-implantitis (Groups 1 and 2), and 20 non-smokers without peri-implantitis (Group 3). Demographic data and information related to cigarette smoking was recorded. Peri-implant clinicoradiographic parameters (plaque index [PI], gingival index [GI], probing depth [PD] and crestal bone loss [CBL]) were assessed. The PISF samples were collected and levels of suPAR and TNF-α were measured. Sample-size estimation was performed and all parameters were statistically assessed. Level of significance was set at P< 0.05. RESULTS: Sixty individuals were included in Groups 1, 2 and 3 (20 in each). Peri-implant PI (P< 0.01), PD (P< 0.01) and mesial (P< 0.01) and distal (P< 0.01) CBL were significantly higher in Group 1 than in Groups 2 and 3. The PISF volume (P< 0.01) and suPAR (P< 0.01) and TNF-α levels (P< 0.01) were significantly higher in Groups 1 and 2 than in Group 3. There was no difference in PISF volume and suPAR and TNF-α levels between patients in Groups 1 and 2. In Group 2, there was a statistically significant correlation between peri-implant PD and PISF suPAR and TNF-α levels (P< 0.01). The suPAR and TNF-α levels are expressed in high concentrations in the PISF of smokers and non-smokers with peri-implantitis compared with non-smokers without peri-implantitis. CONCLUSION: In non-smokers, PISF suPAR and TNF-α levels are correlated with peri-implant PD.

Keywords: Cigarette smoking, peri-implantitis, peri-implant sulcular fluid, soluble urokinase plasminogen activator receptor, tumor necrosis factor-alpha

DOI: 10.3233/THC-213123

Journal: Technology and Health Care, vol. 31, no. 1, pp. 1-9, 2023