Periodontal healing and periopathogenic microflora in smokers and non‐smokers

Abstract

The aim of the present study was to monitor the clinical and microbiological effects of non-surgical therapy in smokers and non-smokers. The subject material included 32 patients (age range 32-61 years), 11 men and 21 women with moderate to severe periodontitis. 17 patients were smokers ( > or = 15 cigarettes/day) and 15 non-smokers. All patients were subjected to non-surgical periodontal therapy performed by a dental hygienist. Periodontal variables (plaque index, gingival index and probing depth) were registered and bacterial samples were collected before and 2 months after treatment. The treatment resulted in significant reductions towards very low plaque and gingival indices in smokers and non-smokers alike (p < 0.05). Although probing depth was reduced in both smokers and non-smokers, the probing pocket depth reduction was significantly smaller in smokers than non-smokers (p < 0.05). Microbiologically, the same therapeutical efficacy was attained in both smoking groups, indicating an almost total eradication of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Concerning Prevotella intermedia, out of 14 smokers and 10 non-smokers positive at baseline, 9 and 5, respectively, remained positive after treatment. The results suggest a less favourable clinical outcome of non-surgical therapy in smokers than non-smokers in spite of the fact that the therapy was equally effective with regard to reducing the alleged periopathogens A. actinomycetemcomitans, P. gingivalis and P. intermedia.

Nonsurgical Recovery of Interdental Papillae under Supportive Periodontal Therapy

“…Bergström and Preber 4) suggested that inflammatory gingival response to plaque accumulation, such as bleeding, redness and exudation, is suppressed by cigarette smoking. Periodontal healing function is poor in smokers 9,14) . This may have affected the amount of time required for improvement in gingival recession.…”

“…Nonsurgical approaches to treating gingival recession of interdental papillae include correction of traumatic oral hygiene methods, restorative treatment, the orthodontic approach and repeated curettage of the papilla 13) . To the best of our knowledge, however, only a few reports have shown recovery of the interdental papillae by a nonsurgical method, and in those cases the recovery occurred during initial periodontal therapy 17) and without periodic curettage 14,18) . In terms of recession on the labial surface, several reports have demonstrated successful root coverage resulting from non-surgical therapy [1][2][3]12,13,15) .…”

Association Between Smoking And Periodontal Disease : A Review Of The Literature

“…With regards to the subgingival plaque microbiota, A. actinomycetemcomitans and P gingivalis were almost totally eradicated and P intermedius was reduced to about 30% in both groups (55). A study by Grossi et al in 1997 (59) showed that current smokers have less healing and reduction in subgingival Bacteroids forsythus and POlphyromonas gingivalis after treatment compared to former and non-smokers, suggesting that smoking impair periodontal healing.…”

“…The influence of smoking on the short-term outcome of non-surgical therapy clinically as well as microbiologically was evaluated (55). The clinical results showed a statistically significant reduction of pocket depth and number of diseased sites in both smokers and nonsmokers patients.…”

Effects of Tobacco Smoking on Chronic Periodontitis and Periodontal Treatment

“…A meta-analysis by Labriola et al (2005) evaluated the impact of smoking on non-surgical periodontal therapy and reported that probing depth reduction in sites where probing depth was initially equal to or more than 5 mm was significantly greater in non-smokers than in smokers in eight studies (Grossi et al 1997, Mongardini et al 1999, Palmer et al 1999, Preber et al 1995, Pucher et al 1997, Renvert et al 1998, Ryder et al 1999, Williams et al 2001.…”