The influence of gingival margin recession on loss of clinical attachment in alcohol-dependent patients without medical disorders.
BACKGROUND
The objective of this study was to examine the effects of alcohol and cocaine misuse on periodontal status in a group of alcohol-dependent patients.


METHODS
Forty verified alcoholics, either exclusively (n = 10) or with cocaine abuse (n = 30), and a matched comparison group of 25 non-alcoholic subjects, 14 of whom abused cocaine, were entered in the study. All subjects were free from systemic illnesses. Blood levels of gamma glutamyl transpeptidase (GGTP), a liver enzyme indicator of alcohol drinking, were determined. A comprehensive periodontal examination was performed on 6 sites per tooth. The gingival index (GI) and plaque index (PI) were recorded. Attachment levels (AL) were computed as probing depth (PD) plus gingival margin level (GM).


RESULTS
No statistically significant differences were noted between the groups for average AL, PD, GM, GI, and PI. In alcoholics, Pearson correlation showed a positive association between GGTP levels and loss of periodontal attachment (P<0.05). A series of regression analyses predicting AL from selected periodontal and demographic factors showed that alcoholics manifest AL by greater increases in GM than non-alcoholics (P<0.07). Severe alcohol use as measured by GGTP >51 iu/l worsens PI (P<0.07), which adversely impacts GM, GI, PD, and ultimately AL. No significant associations were found between cocaine use and AL.


CONCLUSIONS
The results suggest that persistent alcohol abuse increases periodontitis development by heightening the loss of attachment through recession of gingival margins.
Medical College of Georgia, School of Dentistry, Augusta, GA 30912-1220, USA. akhocht@mail.mcg.edu
Ahmed
A
Khocht
Malvin
M
Janal
Steven
S
Schleifer
Steven
S
Keller
D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000097:blood / Q000150:complications* / Q000201:enzymology; D000704:Analysis of Variance; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders; D003774:Dental Plaque Index; D005260:Female; D005889:Gingival Recession / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000097:blood / Q000209:etiology*; D010512:Periodontal Index; D012044:Regression Analysis; D012737:Sex Factors; D012907:Smoking; D018709:Statistics, Nonparametric; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase