Site‐specific treatment outcome in smokers following 12 months of supportive periodontal therapy

Abstract

AimTo evaluate the effect of cigarette smoking on periodontal health at patient, tooth, and site levels following supportive therapy.Materials and MethodsEighty chronic periodontitis patients, 40 smokers and 40 non‐smokers, were recruited to a single‐arm clinical trial. Periodontal examinations were performed at baseline (T0), 3 months following active periodontal therapy (T1), and 12 months following supportive periodontal therapy (T2). Smoking status was validated measuring serum cotinine levels. Probing depth (PD) ≥ 5 mm with bleeding on probing (BoP) was defined as the primary outcome. Logistic regression analyses adjusted for clustered observations of patients, teeth, and sites and mixed effects models were employed to analyse the data.ResultsAll clinical parameters improved from T0 to T2 (p < 0.001), whereas PD, bleeding index (BI), and plaque index (PI) increased from T1 to T2 in smokers and non‐smokers (p < 0.001). An overall negative effect of smoking was revealed at T2 (OR = 2.78, CI: 1.49, 5.18, p < 0.001), with the most pronounced effect at maxillary single‐rooted teeth (OR = 5.08, CI: 2.01, 12.78, p < 0.001). At the patient level, less variation in treatment outcome was detected within smokers (ICC = 0.137) compared with non‐smokers (ICC = 0.051).ConclusionSmoking has a negative effect on periodontal health following 12 months of supportive therapy, in particular at maxillary single‐rooted teeth.

Cumulative smoking exposure and cessation associated with the recurrence of periodontitis in periodontal maintenance therapy: A 6‐year follow‐up

“…There was a significant dose‐response relationship between pack‐years of smoking and the RP, as well as a significant decrease in the risk for the RP as the years of smoking cessation increased. Thus, results from the present study are consistent with the findings from previous studies in PMT that reported worse periodontal clinical conditions and greater RP in CS in relationship to FS and NS …”

“…Thus, results from the present study are consistent with the findings from previous studies in PMT that reported worse periodontal clinical conditions and greater RP in CS in relationship to FS and NS. [1][2][3][4]11,[27][28][29] Significant differences in relationship to periodontal status at T2 among CS reveal a worse response to periodontal treatment and to PMT procedures in the presence of smoking. In addition, CS presented significantly more sites with RP than FS and NS (CS > FS > NS).…”

Long‐term tooth retention in chronic periodontitis – results after 18 years of a conservative periodontal treatment regimen in a university setting

“…A recently published trial with an observation period of 12 months of SPT found a similar hazard (OR 2.78) of tooth loss in smokers compared with never smokers (Bunaes et al. ). However, it needs to be highlighted that in absolute terms, the impact of smoking might be limited: in the current investigation, 15% of never smoker and 21% of former smoker lost no teeth compared to 13% of smokers.…”

Effects of smoking on non‐surgical periodontal therapy in patients with periodontitis Stage III or IV, and Grade C

“…Smokers have been reported to have a higher risk for unresponsive pockets and further breakdown during supportive periodontal treatment. 2 Non-smokers with periodontitis exhibited better healing responses than smokers. 16 However, another study reported contradicting data as both non-smokers and smokers exhibited similarly significant reductions in PD and bleeding scores between baseline and 6 months after non-surgical periodontal treatment.…”

“…1 Furthermore, smoking adversely affects the outcomes of non-surgical periodontal treatment. 2 Less reduction in probing depth and clin-ical attachment gain have been found in smoker periodontitis patients compared with their non-smoker counterparts following non-surgical periodontal treatment. 3 Smoker patients with aggressive periodontitis (AgP) have been reported not to respond well to mechanical non-surgical periodontal treatment.…”