Effect of scaling and root planing on gingival crevicular fluid cytokine/chemokine levels in smokers with chronic periodontitis: A systematic review

In the present study, the impact of scaling and root planing (SRP) on gingival crevicular fluid (GCF) cytokine/chemokine levels in smokers with chronic periodontitis was assessed. The PICO (population, intervention, comparison, outcome) question was: In smokers with chronic periodontitis (population), what is the effect of SRP (intervention) in comparison to SRP in non‐smokers with chronic periodontitis (comparison) on the GCF cytokine/chemokine level (outcome)? Indexed databases were searched up to September 2017. Of 4330 titles, nine studies reporting the levels of 13 different cytokines/chemokines were included. Eight studies had a moderate risk of bias, while one study had a high risk of bias. Almost all cytokines/chemokines were pro‐inflammatory cytokines. Five cytokines/chemokines studied in four clinical studies were decreased in the smoker‐chronic periodontitis group following SRP. One study observed that the GCF levels of interleukin‐17 increased, while anti‐inflammatory osteoprotegerin was reduced in both the SCP and non‐smoker‐chronic periodontitis groups at follow up. However, the majority of cytokines/chemokines did not change in the SCP groups at follow up. The current weight of evidence is not sufficient to prove that SRP has an impact on GCF cytokine/chemokine profile in smokers with chronic periodontitis. Evaluation of wide panels of pro‐inflammatory cytokines/chemokines related to collagen degradation and alveolar bone destruction in future studies are warranted.