title: Prognostic factors in the treatment of generalized aggressive periodontitis: II. Effects of smoking on initial outcome.
abstract: 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.
authors.affiliation: Collaborative Group in Risk Factors for Periodontal Disease, Centre for Adult Oral Health, Institute of Dentistry, London, UK. f.j.hughes@qmul.ac.uk
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Hughes
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Syed
authors.forename: Bindhu
authors.initials: B
authors.lastname: Koshy
authors.forename: Nagihan
authors.initials: N
authors.lastname: Bostanci
authors.forename: Ian J
authors.initials: IJ
authors.lastname: McKay
authors.forename: Michael A
authors.initials: MA
authors.lastname: Curtis
authors.forename: Wagner
authors.initials: W
authors.lastname: Marcenes
authors.forename: Raymond E
authors.initials: RE
authors.lastname: Croucher
mesh_terms: 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