Prognostic factors in the treatment of generalized aggressive periodontitis: II. Effects of smoking on initial outcome.
OBJECTIVE
The aim of this study was to investigate the effects of smoking on the response to non-surgical treatment for aggressive periodontitis.


METHODS
Seventy-nine patients with generalized aggressive periodontitis were included in the study; 20 were smokers. All patients received a course of non-surgical periodontal therapy and outcomes assessed 10 weeks post-operatively. Non-responding patients were designated if they had 30% or more non-responding deep sites.


RESULTS
At baseline, bleeding scores were lower in smokers. There was no difference in baseline plaque, pocket depth (PD), recession or clinical attachment levels (CALs); when sites were selected by equal levels of CAL, increased recession was seen in smokers. Outcomes were poorer in smokers (mean PD change 1.75+/-0.56 versus 2.23+/-0.87 mm). The odds ratio for 30% of sites not responding in smokers was 2.9; for 40% non-responding it was 5.9. Smoking altered the distribution of site-specific responses to increase specifically the number of non-responding sites. There was no significant difference in responses between ex-smokers and never-smokers.


CONCLUSIONS
The results demonstrate that smoking is a major risk factor for poor response to initial treatment and emphasize the importance of smoking cessation in periodontal therapy.
Hughes
Francis J
FJ
Collaborative Group in Risk Factors for Periodontal Disease, Centre for Adult Oral Health, Institute of Dentistry, London, UK. f.j.hughes@qmul.ac.uk
Syed
Mahnaz
M
Koshy
Bindhu
B
Bostanci
Nagihan
N
McKay
Ian J
IJ
Curtis
Michael A
MA
Marcenes
Wagner
W
Croucher
Raymond E
RE
D000328:Adult; D015331:Cohort Studies; D003773:Dental Plaque / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000628:therapy; D005889:Gingival Recession / Q000628:therapy; D006801:Humans; D008297:Male; D017622:Periodontal Attachment Loss / Q000628:therapy; D010514:Periodontal Pocket / Q000628:therapy; D010518:Periodontitis / Q000628:therapy*; D011379:Prognosis; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology*; D016896:Treatment Outcome