GCF MMP-8 Levels in Smokers and Non-Smokers With Chronic Periodontitis Following Scaling and Root Planing Accompanied by Systemic Use of Flurbiprofen Bu ¨lent Kurtis,* Gu ¨lay Tu ¨ter,* Muhittin Serdar, † Selin Pinar,* Ilkim Demirel,* and Utku Toyman* Background: Cigarette smoking has been identified as an important risk factor for the initiation and progression of chronic periodontitis (CP). The aim of this study was to investigate the effects of phase I peri- odontal therapy and adjunctive flurbiprofen administration on matrix metalloproteinase (MMP)-8 levels in gingival crevicular fluid (GCF) samples from smoking and non-smoking patients with CP. Methods: Twenty-nine non-smoking and 29 smoking patients with CP were divided into four groups according to periodontal treatment modalities. Group 1 (non-smokers with CP) and group 3 (smokers with CP) patients received daily 100-mg flurbiprofen tablets in a 2 · 1 regimen for 10 days together with scaling and root planing (SRP). Pa- tients in group 2 (non-smokers with CP) and group 4 (smokers with CP) received placebo tablets in a 2 · 1 regimen for 10 days together with SRP. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) measurements were recorded; GCF samples were collected from each sampling area at baseline and after the 10-day period of drug intake by a single examiner who was unaware of the treatment modality. Assays for GCF MMP-8 were carried out by an enzyme-linked immunosorbent assay. Results: All groups showed statistically significant reductions in PI and GI scores following the phase I periodontal treatment (P <0.05), but no statistical differences were observed in PD and CAL scores after therapy. In all groups, the reduction of GCF MMP-8 levels after therapy was statistically significant compared to baseline levels (P <0.001). When groups 1 and 3 and 2 and 4 were compared according to GCF MMP-8 levels after the therapy, no statistically significant differences were observed (P = 0.117 and P = 0.485, respectively). Conclusion: Flurbiprofen administration had no additional inhibitory effect over SRP alone on GCF levels of MMP-8 in smokers compared to non-smokers with CP. J Periodontol 2007;78:1954-1961. KEY WORDS Chronic periodontitis; flurbiprofen/therapeutic use; gingival crevicular fluid; matrix metalloproteinase-8; smoking. P eriodontitis is character- ized by chronic infection and inflammation in sup- porting periodontal tissues, causing destruction of peri- odontal connective tissues, loss of periodontal attachment, and resorption of alveolar bone. The matrix metalloproteinases (MMPs) are a group of impor- tant enzymes that cause the remodeling and degradation of connective tissue in pathologic tissue turnover, and imbalance between activated MMPs and their endogenous inhibitors lead to breakdown of extracel- lular matrix in periodontitis. 1,2 On the vascular level, during periodontal inflammation un- der the stimulation of bacterial pathogens and their products, polymorphonuclear leukocytes (PMNs) and macrophages syn- thesize a broad spectrum of matrix-degrading proteases, called MMPs. 2,3 MMPs also are produced by fibroblasts, 4 kera- tinocytes, 5 and endothelial cells. 6 Elevated levels of MMPs in gingival tissue and gingival crevicular fluid (GCF) during * Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey. † Department of Biochemistry, Gu ¨lhane Military Medical Academy, Ankara, Turkey. doi: 10.1902/jop.2007.070149 Volume 78 • Number 10 1954