Abstract
Background and Objective: Inhalation of chemicals and toxins in cigarette and hookah smoke results in loss of integrity of oral cavity tissues. The objective of this study was to compare the periodontal health of hookah and cigarette smokers.
 
 Materials and Methods: In this study, 73 men at the age group of 20-35 years who smoked hookah for more than 5 years and 73 men at the same age who smoked cigarette for more than 5 years and 73 healthy men referred to the periodontal department of Mashhad dentistry school were selected and studied. Periodontal indices including pocket depth, GI, BOP, CAL were assessed in two groups. Also, using parallel periapical radiography, mesial and distal marginal bone level around the first molar tooth was measured. Finally, the data were assessed and compared using appropriate statistical analysis.
 
 Results: Pocket depth was 24.27% and 23.62%, respectively, in cigarette smokers and hookah smokers, and it was 0.96% in healthy subjects, clinical attachment level was 4.48 and 4.41 mm, respectively, in cigarette smokers and hookah smokers, and it was 0.77 mm in healthy subjects. Gingival index (GI) was 1.40 and 1.42, respectively, in cigarette smokers and hookah smokers and it was 0.52 in healthy subjects, BOP value was 6.52 and 6.52%, respectively, in cigarette smokers and hookah smokers and it was 10.86% in healthy subjects. Mesial marginal bone level of first lower molar tooth was 2.27 and 2.32 mm, respectively, in cigarette smokers and hookah smokers and it was 1.74 mm in healthy subjects and distal marginal bone level of lower first molar tooth was 2.38 and 2.35 mm, respectively, in cigarette smokers and hookah smokers and it was 1.75 mm in healthy subjects. Comparison of results between the two groups of cigarette smokers and hookah smokers did not show any significant relationship in any of the variables, but there was a significant relationship between the two groups and the healthy group (P <0.001).
 
 Conclusion: Periodontal parameters in healthy individuals are significantly better than those of smokers. Also, although there is a relationship between cigarette smoking and hookah smoking and periodontal parameters, these two groups do not show a significant difference in terms of periodontal parameters.
Highlights
Periodontitis is an inflammatory disease of the supporting tissues of the tooth, caused by certain microorganisms, resulting in the progressive degradation of the periodontal ligament and the alveolar bone and formation of pocket, gingival degradation, or both
Comparison of results between the two groups of cigarette smokers and hookah smokers did not show any significant relationship in any of the variables, but there was a significant relationship between the two groups and the healthy group (P
There is a relationship between cigarette smoking and hookah smoking and periodontal parameters, these two groups do not show a significant difference in terms of periodontal parameters
Summary
Periodontitis is an inflammatory disease of the supporting tissues of the tooth, caused by certain microorganisms, resulting in the progressive degradation of the periodontal ligament and the alveolar bone and formation of pocket, gingival degradation, or both. Specific clinical findings in patients with chronic periodontitis include the formation of upper gingival and sub-gingival plaque (which is often associated with germ formation), gingival inflammation, pocket formation, attachment loss, and alveolar bone resorption (Nurman & Takei, 2002). It is a multifactorial disease and a major etiologic factor in the development of periodontal disease of microorganisms, but the disease progresses due to risk factors such as genetics, age, gender, local factors (improper dental restoration, structural form of tooth, root fractures, root canal segment resorption), systemic factors (HIV, diabetes), environmental factors (smoking, stress) and socioeconomic factors. The objective of this study was to compare the periodontal health of hookah and cigarette smokers
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