Site-specific treatment outcome in smokers following non-surgical and surgical periodontal therapy

Dagmar F Bunaes, Stein Atle Lie, Morten Enersen, Anne Nordrehaug Aastrøm, Kamal Mustafa, Knut N Leknes, Dagmar F Bunaes, Stein Atle Lie, Morten Enersen, Anne Nordrehaug Aastrøm, Kamal Mustafa, Knut N Leknes

Abstract

Aim: To evaluate the effect of smoking at patient, tooth, and site level following non-surgical and surgical periodontal therapy.

Material and methods: Eighty chronic periodontitis patients, 40 smokers and 40 non-smokers, were recruited to this single-arm clinical trial. Smoking status was validated by measuring serum cotinine levels. Periodontal examinations were performed at baseline (T0) and 3 months following non-surgical and surgical periodontal therapy (T1). At T0 and T1, subgingival plaque samples were collected from the deepest periodontal pocket in each patient and analysed using checkerboard DNA-DNA hybridization. Probing depth (PD) ≥ 5 mm with bleeding on probing (BoP) was defined as the primary outcome. Unadjusted and adjusted logistic regression analyses, corrected for clustered observations within patients and teeth, were conducted comparing smokers with non-smokers.

Results: Clinical parameters significantly improved in both groups (p < 0.001). An association was revealed between smoking and PD ≥ 5 mm with BoP (OR= 1.90, CI: 1.14, 3.15, p = 0.013), especially for plaque-positive sites (OR= 4.14, CI: 2.16, 7.96, p < 0.001). A significant reduction of red complex microbiota was observed for non-smokers only (p = 0.010).

Conclusion: Smokers respond less favourably to non-surgical and surgical periodontal therapy compared with non-smokers, in particular at plaque-positive sites.

Keywords: chronic periodontitis; cluster analysis; microbiology; periodontal therapy; smoking.

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Mean percentage of sites showing probing depth reduction of one mm or more between T0 and T1 for each probing depth category.
Figure 3
Figure 3
(a) Number of patients harbouring different pathogens at baseline. (b) Number of patients harbouring different pathogens following non‐surgical and surgical periodontal therapy. *Statistical significant differences between the groups.

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