Objectives: Cigarette smoking has considerable negative effects on dental health. The mechanisms behind these effects are incompletely understood but may be related to host response. The purpose of this study was to investigate the influence of cigarette smoking on periapical exudates levels of prostaglandin E2 (PGE2) and neutrophil elastase (NE). Methods: The study population included nineteen smokers (10 patients smoke <10 cigarettes/day and 9 patients smoke >10 cigarettes/day) and 18 non-smoker patients (mean age: 28.9 years). Periapical exudate samples were obtained from root canals of 39 endodontically involved single rooted-teeth (21 teeth in smokers and 18 teeth in non-smokers) during routine root canal treatment. PGE2 levels were determined by enzyme immunoassay. NE levels were determined in ELISA plates by measurement of p-nitroanilide resulting from hydrolysis of neutrophil elastase-specific peptide, N-methoxysuccinil-Ala-Ala-Pro-Val-p-nitroanilide. PGE2 and NE levels were calculated both as total amounts and concentrations. The presence of spontaneous pain, swelling, pain on palpation or percussion, fistula formation, pus discharge were recorded. Radiographic evaluation was done at sampling time. PGE2 and NE levels in periapical exudates were compared between groups by using Mann Whitney U test. Results: Although the smokers tended to exhibit higher concentrations and total amounts of PGE2 and NE levels than non-smokers, differences were not statistically significant (P>0.05).Total amount of PGE2 in canals with larger radiolucent areas (long axis >1 cm) were significantly higher than those with small areas (P<0.05). Conclusions: Based on the findings of this study, periapical exudate levels of PGE2 and NE did not differ in smokers and non-smokers, suggesting that the influence of smoking on these constituents of periapical exudates from root canals is limited.

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