Smoking enhances bone loss in anterior teeth in a Brazilian population: a retrospective cross-sectional study

Abstract

The aim of the present study was to radiographically evaluate the effect of smoking on bone loss resulting from chronic periodontitis. Periapical radiographs were analyzed of 80 patients with chronic periodontitis (40 current or former smokers and 40 never-smokers) that attended a private periodontal practice. The smokers or former-smokers with a minimum consumption of 10 cigarettes/day for a period of over 10 years were selected. Interproximal radiographic bone loss was considered as the distance between the cementum-enamel junction and the alveolar bone crest. Bone loss for smokers was higher than that observed in never-smokers (p < 0.05) (3.33 +/- 1.09 mm and 2.24 +/- 0.76 mm; mean +/- standard deviation for smokers and non-smokers, respectively). When each region of the mouth was comparatively evaluated, it was observed that the smokers' incisors presented the highest bone loss when compared with the other groups of teeth (p < 0.01). Within the limits of the present investigation it can be concluded that smoking enhances the bone loss resulting from periodontitis and that the incisors are the teeth most affected.

Smoking and periodontal tissues: a review

“…Susin et al 6 evaluated a representative sample of the Porto Alegre population (Rio Grande do Sul State, Brazil) and observed that smokers with moderate and strong dependence had 2.0 and 3.6 more risk, respectively, of having clinical attachment loss ≥ 5 mm than subjects who did not smoke. In another investigation, Lima et al 23 concluded that smoking enhances bone loss resulting from periodontitis.…”

Aspectos clínicos, microbiológicos e tratamento periodontal em pacientes fumantes portadores de doença periodontal crônica: revisão da literatura

“…A nicotina tem sido associada a várias alterações celulares que podem contribuir para o início e posterior progressão da doença periodontal e, de acordo com Lima et al, 10 o desequilíbrio da concentração de nicotina pode levar alterações na resposta inflamatória. Baixa concentração de nicotina pode estimular a quimiotaxia dos neutrófilos, no entanto, altas concentrações podem prejudicar a fagocitose.…”

“…Essas alterações devem-se aos efeitos da nicotina no tecido periodontal, que dificulta a chegada das células inflamatórias no tecido e no sulco gengival, comprometendo o sistema de defesa local. 10 Para Bergstrom e Preber, 13 o desenvolvimento do processo inflamatório em fumantes é retardado, quando comparados ao desenvolvimento em não fumantes. Entretanto, Bastiaan et al 14 18 estudaram o número médio de sítios por pessoa, no qual houve piora em relação à profundidade de sondagem e perda de inserção ao longo de 10 anos, sendo que os tabagistas tiveram piora de 1,5 mm de profundidade de sondagem em comparação com os não fumantes que apresentaram 1,4 mm, sem diferença significativa.…”

Prevalence of periodontopathogens and Candida spp. in smokers after nonsurgical periodontal therapy – a pilot study

“…1,2 Several studies all around the world have pointed out a strong association between tobacco use/smoking habit and periodontal disease, evidenced by greater clinical attachment loss, gingival recession, and tooth loss, 3,4,5 as well as by reduced bone height and density. 6,7,8 The harmful effects of smoking on periodontal tissues are caused by cytotoxic and vasoactive substances present in tobacco, including nicotine, carbon monoxide, and reactive oxygen species. These substances cause oxidative stress and alter immunoinflammatory responses, reducing the functional activity of leukocytes, macrophages, lymphocytes, and other immune cells, and impairing wound healing and microbial identification.…”