Impact of Smoking on Macrophage-Related Chemokines During Initial Peri-Implantitis: A Prospective Cohort Study

Clin Implant Dent Relat Res. 2025 Jun;27(3):e70052. doi: 10.1111/cid.70052.

Abstract

Objectives: Smoking disrupts macrophage chemokine response and delays healing. This study aims to investigate the effect of smoking on peri-implant crevicular fluid (PICF) levels of macrophage-related chemokines, C-C motif chemokine ligand 2 (CCL-2), C-C motif chemokine ligand 8 (CCL-8), C-X-C motif chemokine ligand 9 (CXCL-9), and C-C motif ligand 3 (CCL-3), before and after non-surgical treatment of initial peri-implantitis.

Methods: Fifty-five implants (27 non-smoking [NSPI] and 28 smoking [SPI]) with initial peri-implantitis (bleeding on probing [BOP+], probing pocket depth [PPD] of 6-7 mm) were included in the study. Clinical parameters were recorded, and PICF samples were collected before and 4 months after non-surgical treatment. PICF concentrations of CCL-2, CCL-8, CCL-3, and CXCL-9 were measured with Luminex assay. The Mann-Whitney U-test, Wilcoxon signed-rank test, and repeated measures analysis of variance test were used to analyze differences between and within the groups.

Results: Baseline CCL-2 (p < 0.001) and CXCL-9 (p = 0.026) levels (pg/30 s) were significantly lower in smokers compared to non-smokers, while no difference was observed for CCL-3 between the two groups (p = 0.320). Only CCL-2 levels (pg/30 s) decreased in the NSPI group in response to non-surgical treatment (p = 0.037).

Conclusion: Smoking disturbs the expressions of macrophage-related chemokines in the early phase of peri-implantitis. These findings may indicate the impaired control of infection during initial peri-implantitis and explain the accelerated progression of the disease in smokers. This study was not registered prior to participant recruitment.

Trial registration: https://clinicaltrials.gov/study/NCT06810401.

Keywords: chemokine; peri‐implantitis; smoking.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Chemokine CCL3 / metabolism
  • Chemokines* / metabolism
  • Female
  • Gingival Crevicular Fluid* / chemistry
  • Humans
  • Macrophages* / metabolism
  • Male
  • Middle Aged
  • Peri-Implantitis* / metabolism
  • Peri-Implantitis* / therapy
  • Prospective Studies
  • Smoking* / adverse effects
  • Smoking* / metabolism

Substances

  • Chemokine CCL3
  • Chemokines

Associated data

  • ClinicalTrials.gov/NCT06810401