The effect of smoking on the response to periodontal therapy

Abstract

This study evaluated the effect of smoking on the clinical response to non-surgical and surgical periodontal therapy. 74 adult subjects with moderate to advanced periodontitis were treated according to a split-mouth design involving the following treatment modalities: coronal scaling, root planing, modified Widman surgery, and flap with osseous resectional surgery. Clinical parameters assessed included probing depth, probing attachment level, horizontal attachment level in furcation sites, recession, presence of supragingival plaque and bleeding on probing. Data were collected: initially, 4 weeks following phase-I therapy, 10 weeks following phase-II therapy and on a yearly basis during 6 years of maintenance care. Data analysis demonstrated that smokers exhibited significantly less reduction of probing depth and less gain of probing attachment level when compared to non-smokers immediately following active therapy and during each of the 6 years of maintenance (p < 0.05). A greater loss of horizontal attachment level was evident in smokers at each yearly exam during maintenance therapy (p < 0.05). There were no differences between groups in recession changes. In general, these findings were true for the outcomes following all 4 modalities of therapy and were most pronounced in the deepest probing depth category (> or = 7 mm). Statistical analysis showed a tendency for smokers to have slightly more supragingival plaque and bleeding on probing. In summary, smokers responded less favorably than non-smokers to periodontal therapy which included 3-month maintenance follow-up.

Effect of Periodontal Therapy on Crevicular Fluid Interleukin-6 and Interleukin-8 Levels in Chronic Periodontitis

“…Smoking is an important environmental risk factor for the initiation and progression of periodontitis [51–53]. In agreement with previous findings [53], our results showed that smoking did not influence significantly IL-6 levels in GCF, although there was a trend for higher IL-6 levels in nonsmokers compared to smokers, significantly at 6 weeks following therapy.…”

Periodontal Status in Smokers and Nonsmokers: A Clinical, Microbiological, and Histopathological Study

“…However, the available evidence support this hypothesis in humans is not concluded, as smoking can cause vasodilatation in some tissues. Contradicting these results, some studies have shown increased gingival bleeding [3, 48, 49]. …”

Dentin hypersensitivity: pain mechanisms and aetiology of exposed cervical dentin

“…Smoking is a risk factor strongly associated with periodontitis and will increase the likelihood of recession in periodontal tissues, depending on the number of cigarettes smoked daily and the duration of the habit [63, 64], being more pronounced in men than in women [63] and particularly after periodontal regenerative surgical procedures [65, 66]. …”