{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T23:35:06Z","timestamp":1788478506516,"version":"build-2803163510"},"reference-count":69,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011970","name":"International Team for Implantology","doi-asserted-by":"publisher","award":["1581\u20102021"],"award-info":[{"award-number":["1581\u20102021"]}],"id":[{"id":"10.13039\/501100011970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Oral Implants Res"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The study aimed to investigate the relationship between cigarette smoking and macrophage polarization in peri\u2010implantitis (PI) lesions. Additionally, it sought to characterize clinical, radiological, microbiological, and immunological features of PI in smokers and non\u2010smokers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A cross\u2010sectional study included 40 patients (20 smokers, \u2265\u200910 cigarettes\/day, and 20 non\u2010smokers) requiring surgical treatment for PI. Samples of peri\u2010implant crevicular fluid (PICF) and granulation tissue were collected during surgery for immunofluorescence and cytokine analyses. Smoking exposure was assessed through cotinine levels. Macrophage polarization (M1\/M2) was determined using immunofluorescence. Clinical, radiological, and microbiological parameters were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Smokers showed a significantly higher proportion of M1 macrophages (70.23%) compared to non\u2010smokers (25.09%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.005). This pro\u2010inflammatory shift correlated positively with cotinine levels (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.694; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.005) and pack\u2010years (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.81; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.005). No significant differences in M2 macrophage counts, cytokine concentrations, or microbiota diversity were observed between the groups. However, smokers exhibited more severe PI lesions (<jats:italic>p<\/jats:italic>\u2009=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Smoking is associated with a pro\u2010inflammatory shift at the cellular level due to an increase in M1 macrophage polarization in PI lesions, suggesting a pro\u2010inflammatory response that may exacerbate tissue destruction and hinder treatment outcomes. These findings highlight the need for incorporating smoking cessation into comprehensive peri\u2010implant care strategies to improve disease management and implant prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/clr.14448","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T07:55:31Z","timestamp":1747295731000},"page":"1017-1029","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effects of Smoking on Macrophage Polarization in Peri\u2010Implantitis Lesions"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4907-6888","authenticated-orcid":false,"given":"Ettore","family":"Amerio","sequence":"first","affiliation":[{"name":"Department of Periodontology Universitat Internacional de Catalunya  Barcelona Spain"},{"name":"Department of Biomedical, Surgical and Dental Sciences, Unit of Periodontology University of Milan; Foundation IRCCS Ca' Granda Policlinic  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Sparano","sequence":"additional","affiliation":[{"name":"Department of Periodontology Universitat Internacional de Catalunya  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"Mu\u00f1oz\u2010Sanz","sequence":"additional","affiliation":[{"name":"Enfermedades Infecciosas. 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