Longitudinal evaluation of clinical, spectral and tissue degradation biomarkers in progression of periodontitis among cigarette and electronic cigarette smokers

Objectives: To longitudinally evaluate the periodontal parameters and MMP-8 and CTX (C-terminal crosslinked telopeptide of type I collagen) levels from diseased and healthy sites from cigarette and electronic cigarette (ecig) smokers and characterize the gingival crevicular fluid (GCF) samples using Raman spectroscopy In addition, to longitudinally determine if MMP-8 and CTX are predictive factors for attachment loss in periodontitis sites. Methods: Sixty periodontally healthy and 60 periodontitis/diseased sites from 30 e-cig and 30 cigarette smokers were monitored at baseline, 3 months, and 6-months. GCF was sampled to study the MMP-8 and CTX concentrations using enzyme-linked immunosorbent assay. Infra-red absorption spectra of GCF were acquired at all time points and processed to identify key functional groups. Results: A significantly increased attachment loss was observed at 6 months for both smokers when compared with baseline (p < 0.01). This difference was significantly high for cigarette smokers compared with e-cig users (p < 0.01). MMP-8, CTX, smoking pack-years were significantly correlated with probing depth and clinical attachment loss among both e-cig and cigarette smokers. For MMP-8 and CTX, the periodontitis sites showed a statistically significant difference between e-cig and cigarette smokers at both 3- and 6 months follow-up. From baseline to 6 months follow-up, periodontitis sites from both groups showed higher spectral band intensities with deconvulations and Raman shifts for Amide I and Amide II peaks. Conclusion: Cigarette smokers showed higher periodontal worsening than e-cig smokers. Smoking, MMP-8, CTX are prognostic factors for clinical attachment loss in cigarette and e-cig smokers. Clinical significance: Data for Raman scattering and spectral information identifying collagen degradation among e-cig and cigarette smokers have been analyzed. This type of analysis proves a robust diagnostic and prognostic tool for periodontal diseases. Smoking, MMP-8, and CTX are prognostic factors for clinical attachment loss in cigarette and e-cig smokers.

Automated summary

The study showed that cigarette smokers had higher deterioration of periodontal health compared to e-cigarette smokers. Smoking, MMP-8, and CTX were identified as prognostic factors for clinical attachment loss in both cigarette and e-cigarette smokers.