Assessment of matrix metalloproteinase-8 and-9 levels in the peri-implant sulcular fluid among waterpipe (narghile) smokers and never-smokers with peri-implantitis

Objectives: It is hypothesized that levels of matrix metalloproteinase (MMP)-8 and MMP-9 are significantly higher in the peri-implant sulcular fluid (PISF) of waterpipe-smokers (WS) compared with never-smokers with peri-implantitis. The aim of the present convenience sample case-control study was to compare the levels of MMP-8 and MMP-9 in the PISF of WS and never-smokers with peri-implantitis.Material and Methods: Individuals smoking waterpipe (Group 1) and never-smokers (Group 2) were included. Demographic data was collected using a questionnaire. Peri-implant probing depth (PPD) was measured and crestal bone loss (CBL) was measured on digital bitewing radiographs. PISF samples were collected using paper strips and the collected PISF volume was determined. Levels of MMP-8 and MMP-9 were measured using enzyme-linked immunosorbent assay. Study sample-size was estimated and statistical analysis was performed. pvalues <.05 were considered statistically significant.Results: Sixty-six individuals (33 individuals in Group 1 and 33 in Group 2) were included. In Groups 1 and 2, 41 and 44 implants, respectively were placed. The mean total PPD (p<.001) and peri-implant CBL (p<.001) was statistically significantly higher around implants affected by peri-implantitis in Group 1 compared with Group 2. The PISF volume (p<.05) collected and levels of MMP-8 (p<.01) and MMP-9 (p<.01) were statistically significantly higher among individuals in Group 1 compared with Group 2.Conclusion: PISF levels of MMP-8 and MMP-9 are significantly higher among WS compared with never-smokers with peri-implantitis.