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Another objective of the study was to evaluate the relationship between these biomarkers and periodontitis and to assess the effects of smoking on their levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A total of 45 volunteers, 15 smokers (Group SP) and 15 non-smokers (Group NP) diagnosed with stage 3 periodontitis between the ages of 18 and 60, and 15 healthy individuals (Group H) were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All clinical parameters of the SP and NP groups were found to be significantly higher than those of the H group before NSPT (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001), and a significant reduction was observed in all clinical parameters after phase I treatment (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). Following NSPT, significant improvement was observed in all periodontal parameters in both periodontitis groups (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). Gremlin-1 levels in the SP and NP groups were statistically significantly lower after treatment compared to pre-treatment levels (p&lt;0.05). While there was no statistically significant difference in IL-1\u03b2 levels before and after treatment in the SP group (\n                      <jats:italic>p<\/jats:italic>\n                      &gt;0.05), a statistically significant reduction was observed in the NP group after treatment (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05). Similarly, no statistically significant difference was found in Syndecan-4 levels before and after treatment in the SP group (\n                      <jats:italic>p<\/jats:italic>\n                      &gt;0.05), whereas the post-treatment measurements of the NP group were statistically significantly lower (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After NSPT, Gremlin-1 levels in GCF decreased in both groups, whereas significant reductions in Syndecan-4 and IL-1\u03b2 levels were observed only in non-smokers. These findings suggest that the regulatory effect of smoking on biomarkers may negatively influence the periodontal treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>Smoking is a major risk factor for periodontitis and may impair healing following nonsurgical periodontal therapy. While similar clinical improvements were observed, reductions in IL-1\u03b2 and Syndecan-4 occurred only in non-smokers, whereas Gremlin-1 decreased in both groups. These findings suggest that smoking may influence molecular healing responses, and biomarker monitoring may support personalized periodontal management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-06859-y","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T03:59:20Z","timestamp":1775879960000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of smoking on gremlin-1, syndecan-4, and IL-1\u03b2 responses to non-surgical periodontal therapy in stage 3 periodontitis: a comparative study with periodontally healthy controls"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6301-9771","authenticated-orcid":false,"given":"Yunus Emre","family":"Bayrakdar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9675-5509","authenticated-orcid":false,"given":"Tu\u011fba","family":"Ayd\u0131n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5189-3564","authenticated-orcid":false,"given":"Esra","family":"Lalo\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,11]]},"reference":[{"issue":"1","key":"6859_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/PRD.12221","volume":"75","author":"J Slots","year":"2017","unstructured":"Slots J (2017) Periodontitis: facts, fallacies and the future. 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