Nonsurgical treatment achieves periodontitis improvements regardless of smoking

Sep 11 2012

By Sarah Guy, medwireNews Reporter

Both smokers and nonsmokers with the chronic inflammatory disease periodontitis have significantly improved clinical markers, including probing depth and plaque index, after nonsurgical periodontal therapy, show study results.

Furthermore, at 6 weeks after treatment, levels of interleukin (IL)-1β - thought to contribute to the pathologic process of periodontitis - were significantly lower in all study participants compared with baseline, regardless of smoking status, report the researchers in the Journal of Periodontal Research.

Hulya Toker (Cumhuriyet University, Sivas, Turkey) and colleagues assessed clinical measurements and gingival crevicular fluid samples from 30 patients with periodontitis (15 smokers and 15 nonsmokers) both before and after they underwent scaling and root planning, and compared their results with 10 healthy nonsmoking individuals who acted as controls.

Baseline clinical parameters were significantly higher among all periodontitis patients versus controls, eg, probing depth was 4.8 versus 1.4 mm. However, mean probing depth and clinical attachment reduced significantly after treatment compared with baseline in all periodontitis patients, regardless of smoking status, to depths of 2.7 and 2.8 mm in smokers and nonsmokers, respectively.

Plaque index and gingival index were also significantly lower after treatment compared with baseline in periodontitis patients, at 0.15 and 0.10 versus 1.80 and 1.95, respectively, and again, these results did not differ according to smoking status.

The team observed no pre- or posttreatment differences in total oxidant status (TOS) or total antioxidant status (TAS) in any of the study participants, but that there was a significant, positive correlation between TOS and IL-1β in smokers, and significant, negative correlations between TAS and TOS values in smokers and between TAS and plaque index values in smokers.

"In addition to the direct etiological impact of bacteria, cigarette smoking is considered to be one of the most important environmental risk factors for periodontitis," write Toker and co-investigators.

"Future studies are needed to determine the inter-relationships between oxidant-antioxidant status and cytokines in periodontal disease pathogenesis and the impact of smoking on the inflammatory process," they conclude.

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