Non-surgical Periodontal Treatment in Smokers on SIRT-1, NLRP3 Inflammasome and LncRNAs

"Clinical Measurements and Laboratory Measurement Saliva and serum samples will be collected from all patients initially. Clinical parameters will also be recorded initially. Plaque index (PI) and gingival index (GI) will be recorded at four sites per tooth. Full-mouth probing depth (PD) and clinical attachment level (CAL) will be detailed per tooth at six sites, and the percentage of bleeding areas will be recorded as present or absent within 20 seconds after probing using a binary scoring system. A calibrated periodontologist (ZTE) will record all clinical parameters using manual probing.~Following sampling, both serum and saliva samples will be stored at -80°C until analysis. Concentrations of NLRP3, ASC, caspase-1, IL-18, IL-1beta, TNF-alfa, IL-10, TGF-beta, and SIRT-1 will be analyzed by specific enzyme-linked immunosorbent assay (ELISA) kits in both serum and saliva samples. LncRNA SNHG5 and MEG3 will be examined using Real-time PCR."

Treatment will be performed using ultrasonic devices followed by root planing with gracey curettes. SRP will be completed in two visits, each consisting of quadrants every 2 days. Oral hygiene instructions will include demonstrating proper brushing techniques and the use of interdental cleaning aids as needed. Saliva and serum samples will be collected again at the 3-month follow-up visit, all clinical parameter records will be repeated by the same clinician (ZTE), and oral hygiene instructions will be reconfirmed as needed. After the collection of 3-month records and samples, all patients with persistent pockets will be subjected to a standard periodontitis treatment protocol.

"All clinical and laboratory evaluations described under the heading Before non-surgical periodontal treatment will be repeated in the 3rd month after NSPT."