Evaluation of the Effect of Smoking on Apelin, Periostin, and High-Sensitivity CRP Levels in Gingival Crevicular Fluid and Serum

Periodontal health is influenced by various local and systemic factors, with smoking being one of the major environmental risk factors. This clinical study is designed to investigate the biochemical profiles of individuals by measuring apelin, periostin, and high-sensitivity C-reactive protein (hs-CRP) levels in both gingival crevicular fluid and serum. The participants will be divided into specific study groups based on their smoking status and periodontal condition. Samples of gingival crevicular fluid and serum will be collected under standard clinical protocols, and biomarker concentrations will be analyzed quantitatively using the ELISA (Enzyme-Linked Immunosorbent Assay) method to evaluate their potential correlation with periodontal status.

Inclusion Criteria: General Inclusion Criteria (All Groups): * Age 18 years or older. * No history of systemic diseases that could affect periodontal status. For Group 1 (Non-smoking Periodontally Healthy): * Never smoked in the past 10 years. * Probing pocket depth (PPD) ≤3 mm and no clinical attachment loss (CAL) in the sampled teeth. * Absence of gingival inflammation and no history of periodontal disease. * Bleeding on probing (BOP) affecting less than 10% of total sites. * Good oral hygiene and no more than 4 missing teeth (excluding third molars). For Group 2 (Smoking Periodontally Healthy): * History of smoking at least 10 cigarettes per day for 5 or more years. * Probing pocket depth (PPD) ≤3 mm and no clinical attachment loss (CAL) in the sampled teeth. * Absence of gingival inflammation and no history of periodontal disease. * Bleeding on probing (BOP) affecting less than 10% of total sites. * Good oral hygiene and no more than 4 missing teeth (excluding third molars). For Group 3 (Non-smoking Stage III Periodontitis): * Never smoked in the past 10 years. * Diagnosed with generalized Stage III Periodontitis * Presence of periodontal pockets with probing depth ≥6 mm in the sampled teeth. * Radiographic evidence of bone loss. * Absence of any restoration on the teeth selected for sampling. * No more than 4 missing teeth (excluding third molars). For Group 4 (Smoking Stage III Periodontitis): * History of smoking at least 10 cigarettes per day for 5 or more years. * Diagnosed with generalized Stage III Periodontitis * Presence of periodontal pockets with probing depth ≥6 mm in the sampled teeth. * Radiographic evidence of bone loss. * Absence of any restoration on the teeth selected for sampling. * No more than 4 missing teeth (excluding third molars). Exclusion Criteria: 1. Individuals under the age of 18 2. Individuals with a systemic disease 3. Cancer patients and those with a history of chemotherapy or radiation therapy 4. Pregnant and breastfeeding women 5. People who have quit smoking 6. Having undergone any periodontal surgical procedure within the last 12 months prior to treatment, 7. Having undergone periodontal treatment within the last 6 months 8. Having undergone orthodontic treatment within the last 6 months 9. Having taken antibiotics, anti-inflammatory drugs, or any other medication within the last 6 months