Comparison of cotinine levels in the peri‐implant sulcular fluid among cigarette and waterpipe smokers, electronic‐cigarette users, and nonsmokers

Background Assessment of cotinine levels in the peri‐implant sulcular fluid (PISF) may serve as a valuable biomarker of peri‐implant diseases in nicotine‐product users. Purpose The aim of the present study was to compare cotinine levels in the PISF among cigarette smokers, waterpipe users, electronic‐cigarette users, and nonsmokers. Materials and Methods Cigarette smokers, waterpipe smokers, electronic‐cigarette users, and nonsmokers were included. A questionnaire was used to collect information about age, gender, duration of smoking and vaping, family history of smoking, duration of smoking/vaping, and daily frequency of smoking/vaping. Implant‐related data including implant dimensions and duration of implants in function were also recorded. In all groups, peri‐implant probing depth (PD), bleeding on probing (BoP), and plaque index (PI) were assessed. Using standard techniques, PISF was collected and levels of cotinine in the PISF were measured. Sample‐size estimation was performed, and statistical comparisons were done using one‐way analysis of variance and Bonferroni post hoc adjustment tests. P values below .05 were categorized as statistically significant. Results One hundred two male individuals (35 cigarette smokers, 33 waterpipe smokers, 34 electronic‐cigarette users, and 35 nonsmokers) were included. Scores of peri‐implant PI (P