1
|
Fu L, Khazaeinezhad R, Hariri A, Qi B, Chen C, Jokerst JV. Posterior photoacoustic/ultrasound imaging of the periodontal pocket with a compact intraoral transducer. Photoacoustics 2022; 28:100408. [PMID: 36204181 PMCID: PMC9530592 DOI: 10.1016/j.pacs.2022.100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/15/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Periodontitis is a public issue and imaging periodontal pocket is important to evaluate periodontitis. Regular linear transducers have limitations in imaging the posterior teeth due to their geometry restrictions. Here we characterized a transducer that can image the posterior teeth including assessment of periodontal pockets via a combination of photoacoustic and ultrasound imaging. Unlike conventional transducer design, this device has a toothbrush-shaped form factor with a side-view transducer to image molars (total size: 1 ×1.9 cm). A laser diode was integrated as the light source to reduce the cost and size and facilitates clinical transition. The in vivo imaging of a molar of a periodontal patient demonstrated that the transducer could image in the posterior area of gum in vivo; the value determined by imaging was within 7 % of the value measured clinically.
Collapse
Affiliation(s)
- Lei Fu
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093, USA
| | | | - Ali Hariri
- StyloSonic LLC, Lake Forest, CA 92630, USA
| | - Baiyan Qi
- Materials Science and Engineering Program, University of California San Diego, La Jolla, CA 92093, USA
| | - Casey Chen
- Herman Ostrow School of Dentistry, University of Southern California, 925 West 34th Street, Los Angeles, CA 90089, USA
| | - Jesse V. Jokerst
- Department of NanoEngineering, University of California San Diego, La Jolla, CA 92093, USA
- StyloSonic LLC, Lake Forest, CA 92630, USA
- Materials Science and Engineering Program, University of California San Diego, La Jolla, CA 92093, USA
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| |
Collapse
|
2
|
Abstract
Tobacco smoking has been implicated in periodontal pathology through various mechanisms, including perturbations of the inflammatory and host responses to putative periodontal pathogens, alterations in the subgingival microbial communities, and a compromised healing potential of the tissues leading to imbalance of tissue homeostasis. This review provides the evidence for the relationship between cigarette smoking and periodontal disease in an attempt to explain possible mechanisms of how tobacco smoking may exert its negative effects on the periodontal tissues via systemic and localized pathways. Early and more recent studies explore cigarette smoking-induced changes in periodontal clinical indices; in subgingival microbial flora by employing traditional detection methods for selected microorganisms, in addition to modern techniques such as deep sequencing and bioinformatics analyses that are able to fully characterize the microbial communities; and in inflammatory and immune responses critically appraising study limitations and differences in study protocol designs. Periodontal treatment outcomes and implant therapy outcomes are reviewed in an attempt to shed light on possible mechanisms for the inferior treatment outcome noted in smokers. The potential harmful effects of passive smoking are also reviewed, providing evidence for the advantages of smoking cessation. Quitting cigarette smoking should be recommended by the dentist, and effort should be made to inform smokers about the negative effects of smoking on the periodontal status and implant therapy outcomes.
Collapse
Affiliation(s)
- Danae Anastasia Apatzidou
- Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTh), Thessaloniki, Greece
| |
Collapse
|
3
|
Fu L, Ling C, Jin Z, Luo J, Palma-Chavez J, Wu Z, Zhou J, Zhou J, Donovan B, Qi B, Mishra A, He T, Jokerst JV. Photoacoustic imaging of posterior periodontal pocket using a commercial hockey-stick transducer. J Biomed Opt 2022; 27:JBO-210363GR. [PMID: 35610752 PMCID: PMC9128833 DOI: 10.1117/1.jbo.27.5.056005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 05/02/2022] [Indexed: 06/02/2023]
Abstract
SIGNIFICANCE Photoacoustic imaging has shown advantages over the periodontal probing method in measuring the periodontal probing depth, but the large size of conventional photoacoustic transducers prevents imaging of the more posterior teeth. AIM Our aim is to develop a photoacoustic imaging system to image the more posterior periodontal pocket. APPROACH We report a clinical "hockey-stick"-style transducer integrated with fibers for periodontal photoacoustic imaging. Cuttlefish ink labeled the periodontal pocket as the photoacoustic contrast agent. RESULTS We characterized the imaging system and then measured the pocket depth of 35 swine teeth. Three raters evaluated the performance of the hockey-stick transducer. The measurements between the Williams probing (gold standard) and the photoacoustic methods were blinded but highly correlated. We showed a bias of ∼0.3 mm for the imaging-based technique versus Williams probing. The minimum inter-reliability was over 0.60 for three different raters of varying experience, suggesting that this approach to measure the periodontal pocket is reproducible. Finally, we imaged three pre-molars of a human subject. We could access more upper and posterior teeth than conventional linear transducers. CONCLUSIONS The unique angle shape of the hockey-stick transducer allows it to image more posterior teeth than regular linear transducers. This study demonstrated the ability of a hockey-stick transducer to measure the periodontal pocket via photoacoustic imaging.
Collapse
Affiliation(s)
- Lei Fu
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Chen Ling
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Zhicheng Jin
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Jessica Luo
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Jorge Palma-Chavez
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Zhuohong Wu
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Jingcheng Zhou
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Jiajing Zhou
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Brian Donovan
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
| | - Baiyan Qi
- University of California San Diego, Materials Science and Engineering Program, La Jolla, California, United States
| | - Aditya Mishra
- University of California San Diego, Materials Science and Engineering Program, La Jolla, California, United States
| | - Tengyu He
- University of California San Diego, Materials Science and Engineering Program, La Jolla, California, United States
| | - Jesse V. Jokerst
- University of California San Diego, Department of NanoEngineering, La Jolla, California, United States
- University of California San Diego, Materials Science and Engineering Program, La Jolla, California, United States
- University of California San Diego, Department of Radiology, La Jolla, California, United States
| |
Collapse
|
4
|
Laugisch O, Auschill TM, Heumann C, Sculean A, Arweiler NB. Clinical Evaluation of a New Electronic Periodontal Probe: A Randomized Controlled Clinical Trial. Diagnostics (Basel) 2021; 12:diagnostics12010042. [PMID: 35054209 PMCID: PMC8774924 DOI: 10.3390/diagnostics12010042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 01/19/2023] Open
Abstract
Precise measurements of periodontal parameters (such as pocket depths: PPD, gingival margins: GM) are important for diagnosis of periodontal disease and its treatment. Most examiners use manual millimeter-scaled probes, dependent on adequate pressure and correct readouts. Electronic probes aim to objectify and facilitate the diagnostic process. This randomized controlled trial compared measurements of a standard manual (MP) with those of an electronic pressure-sensitive periodontal probe (EP) and its influence on patients' acceptance and practicability. In 20 patients (2436 measuring points) PPD and GM were measured either with MP or EP by professionals with different levels of experience: dentist (10 patients), 7th and 10th semester dental students (5 patients each). Time needed was measured in minutes and patients' subjective pain was evaluated by visual analogue scale. Differences were analyzed using the generalized estimating equations approach (GEE) and paired Wilcoxon tests. Mean PPD varied with ΔPPD 0.38 mm between both probes, which was significant (p < 0.001), but GM did not (ΔREC 0.07 mm, p = 0.197). There was a statistically significant correlation of both probes (Spearman's rho correlation coefficient GM: 0.674, PPD: 0.685). Differences can be considered robust (no deviation in either direction). The comparison of time needed and pain sensitivity did not result in statistically significant differences (p > 0.05).
Collapse
Affiliation(s)
- Oliver Laugisch
- Department of Periodontology and Peri-Implant Diseases, Philipps-University, 35037 Marburg, Germany; (O.L.); (T.M.A.)
| | - Thorsten M. Auschill
- Department of Periodontology and Peri-Implant Diseases, Philipps-University, 35037 Marburg, Germany; (O.L.); (T.M.A.)
| | - Christian Heumann
- Department of Statistics, Ludwig-Maximilians-University Munich, 80539 Munich, Germany;
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
| | - Nicole B. Arweiler
- Department of Periodontology and Peri-Implant Diseases, Philipps-University, 35037 Marburg, Germany; (O.L.); (T.M.A.)
- Correspondence:
| |
Collapse
|
5
|
Silva H. Tobacco Use and Periodontal Disease-The Role of Microvascular Dysfunction. Biology (Basel) 2021; 10:441. [PMID: 34067557 PMCID: PMC8156280 DOI: 10.3390/biology10050441] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 12/30/2022]
Abstract
Periodontal disease consists in highly prevalent wide-ranging inflammatory conditions that affect the supporting apparatus of teeth. Tobacco use is the most important risk factor for periodontal disease as it increases disease severity and periodontal surgery complications. Tobacco use is harmful for the vasculature by causing microvascular dysfunction, which is known to negatively affect periodontal disease. To the author's knowledge this paper is the first comprehensive review on the mechanisms by which tobacco use affects oral microcirculation and impacts the pathophysiology of periodontal disease. In healthy subjects, acute nicotine administration or tobacco use (smoking/smokeless forms) increases the blood flow in the oral mucosa due to local irritation and increased blood pressure, which overcome neural- and endocrine-mediated vasoconstriction. Chronic tobacco smokers display an increased gingival microvascular density, which is attributed to an increased capillary recruitment, however, these microcirculatory units show higher tortuosity and lower caliber. These morphological changes, together with the repetitive vasoconstrictive insults, contribute to lower gingival perfusion in chronic smokers and do not completely regress upon smoking cessation. In periodontal disease there is considerable gingival inflammation and angiogenesis in non-smokers which, in chronic smokers, are considerably suppressed, in part due to local immune suppression and oxidative stress. Tobacco exposure, irrespective of the form of use, causes long-term microvascular dysfunction that increases the risk of complications due to the natural disease course or secondary therapeutic strategies.
Collapse
Affiliation(s)
- Henrique Silva
- Informetrics Research Group, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam;
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam
| |
Collapse
|
6
|
Naveau A, Shinmyouzu K, Moore C, Avivi-Arber L, Jokerst J, Koka S. Etiology and Measurement of Peri-Implant Crestal Bone Loss (CBL). J Clin Med 2019; 8:E166. [PMID: 30717189 DOI: 10.3390/jcm8020166] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 12/15/2022] Open
Abstract
The etiology of peri-implant crestal bone loss is today better understood and certain factors proposed in the past have turned out to not be of concern. Regardless, the incidence of crestal bone loss remains higher than necessary and this paper reviews current theory on the etiology with a special emphasis on traditional and innovative methods to assess the level of crestal bone around dental implants that will enable greater sensitivity and specificity and significantly reduce variability in bone loss measurement.
Collapse
|
7
|
Abstract
Cigarette smoking presents oral health professionals with a clinical and research conundrum: reduced periodontal vascular responsiveness to the oral biofilm accompanied by increased susceptibility to destructive periodontal diseases. This presents a significant problem, hampering diagnosis and complicating treatment planning. The aim of this review is to summarize contemporary hypotheses that help to explain mechanistically the phenomenon of a suppressed bleeding response to dysbiotic plaque in the periodontia of smokers. The influence of smoke exposure on angiogenesis, innate cell function, the production of inflammatory mediators including cytokines and proteases, tobacco-bacteria interactions, and potential genetic predisposition are discussed.
Collapse
Affiliation(s)
| | - David A. Scott
- Department of Oral Immunology and Infectious Diseases, School of Dentistry, University of Louisville, Louisville, KY, USA
| |
Collapse
|
8
|
Lin CY, Chen F, Hariri A, Chen CJ, Wilder-Smith P, Takesh T, Jokerst JV. Photoacoustic Imaging for Noninvasive Periodontal Probing Depth Measurements. J Dent Res 2017; 97:23-30. [PMID: 28880116 DOI: 10.1177/0022034517729820] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The periodontal probe is the gold standard tool for periodontal examinations, including probing depth measurements, but is limited by systematic and random errors. Here, we used photoacoustic ultrasound for high-spatial resolution imaging of probing depths. Specific contrast from dental pockets was achieved with food-grade cuttlefish ink as a contrast medium. Here, 39 porcine teeth (12 teeth with artificially deeper pockets) were treated with the contrast agent, and the probing depths were measured with novel photoacoustic imaging and a Williams periodontal probe. There were statistically significant differences between the 2 measurement approaches for distal, lingual, and buccal sites but not mesial. Bland-Altman analysis revealed that all bias values were < ±0.25 mm, and the coefficients of variation for 5 replicates were <11%. The photoacoustic imaging approach also offered 0.01-mm precision and could cover the entire pocket, as opposed to the probe-based approach, which is limited to only a few sites. This report is the first to use photoacoustic imaging for probing depth measurements with potential implications to the dental field, including tools for automated dental examinations or noninvasive examinations.
Collapse
Affiliation(s)
- C Y Lin
- 1 Department of NanoEngineering, University of California, San Diego, La Jolla, CA, USA
| | - F Chen
- 1 Department of NanoEngineering, University of California, San Diego, La Jolla, CA, USA.,2 Materials Science and Engineering Program, University of California, San Diego, La Jolla, CA, USA
| | - A Hariri
- 1 Department of NanoEngineering, University of California, San Diego, La Jolla, CA, USA
| | - C J Chen
- 1 Department of NanoEngineering, University of California, San Diego, La Jolla, CA, USA
| | - P Wilder-Smith
- 3 Beckman Laser Institute, University of California, Irvine, CA, USA
| | - T Takesh
- 3 Beckman Laser Institute, University of California, Irvine, CA, USA
| | - J V Jokerst
- 1 Department of NanoEngineering, University of California, San Diego, La Jolla, CA, USA.,2 Materials Science and Engineering Program, University of California, San Diego, La Jolla, CA, USA.,4 Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| |
Collapse
|
9
|
Knight ET, Liu J, Seymour GJ, Faggion CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016; 71:22-51. [DOI: 10.1111/prd.12110] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
|
10
|
Bunaes DF, Lie SA, Enersen M, Aastrøm AN, Mustafa K, Leknes KN. Site-specific treatment outcome in smokers following non-surgical and surgical periodontal therapy. J Clin Periodontol 2015; 42:933-42. [PMID: 26407817 PMCID: PMC6207927 DOI: 10.1111/jcpe.12462] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 11/26/2022]
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.
Collapse
Affiliation(s)
- Dagmar F Bunaes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Stein Atle Lie
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Morten Enersen
- Faculty of Dentistry, Institute of Oral Biology, University of Oslo, Oslo, Norway
| | - Anne Nordrehaug Aastrøm
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Kamal Mustafa
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Knut N Leknes
- Faculty of Medicine and Dentistry, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| |
Collapse
|
11
|
Rosa EF, Corraini P, Inoue G, Gomes EF, Guglielmetti MR, Sanda SR, Lotufo JPB, Romito GA, Pannuti CM. Effect of smoking cessation on non-surgical periodontal therapy: results after 24 months. J Clin Periodontol 2014; 41:1145-53. [DOI: 10.1111/jcpe.12313] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 12/26/2022]
Affiliation(s)
- Ecinele Francisca Rosa
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - Priscila Corraini
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
- Department of Clinical Epidemiology; Aarhus University; Aarhus Denmark
| | - Gislene Inoue
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - Elaine Fueta Gomes
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - Mariana Rocha Guglielmetti
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - Sheila Regina Sanda
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | | | - Giuseppe Alexandre Romito
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - Cláudio Mendes Pannuti
- Division of Periodontics; Department of Stomatology; School of Dentistry; University of São Paulo; São Paulo Brazil
| |
Collapse
|
12
|
Ardais R, Mário TDG, Boligon J, Kantorski KZ, Moreira CHC. The effect of smoking on bleeding on probing after nonsurgical periodontal therapy: a quasi-experimental study. Braz Oral Res 2014; 28:1-7. [PMID: 25337935 DOI: 10.1590/1807-3107bor-2014.vol28.0058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/24/2014] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to evaluate the effect of smoking on response to nonsurgical periodontal therapy using the primary outcome measure of bleeding on probing (BoP). An periodontist performed periodontal therapy on 11 smokers and 14 never smokers with periodontitis. Two examiners assessed visible plaque index, gingival bleeding index, probing pocket depth (PPD), BoP, suppuration on probing and clinical attachment level (CAL), at baseline and three months after therapy. BoP was categorized as 0 (absent), 1 (small bleeding point) and 2 (blood flow from the sulcus). Total BoP value was obtained by summing values of 1 and 2. All subjects had significant reductions in mean PPD and percentages of sites with BoP, with no difference between the groups. Only never smokers presented statistically significant CAL gain. BoP was significantly and consistently reduced at sites with initial PPDs of 1-3 mm and 4-6 mm in both groups. At sites with deep PPD ( ≥ 7mm), never smokers showed a greater mean reduction in the number of sites with BoP than did smokers (p < 0.05). Never smokers had significantly greater reduction in BoP 2 than smokers, at sites with moderate and deep baseline PPDs. The first group had a significant increase of BoP 1, at sites with initial PPDs of 4-6 mm. Thus, periodontal therapy reduced BoP in both groups. However, smoking could negatively affect the BoP reduction at deeper sites after nonsurgical periodontal therapy.
Collapse
Affiliation(s)
- Rodrigo Ardais
- Department of Stomatology, Dental School, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Ticiane de Góes Mário
- Department of Stomatology, Dental School, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Jociana Boligon
- Department of Stomatology, Dental School, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Karla Zanini Kantorski
- Department of Stomatology, Dental School, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | | |
Collapse
|
13
|
Milosavljevic A, Götrick B, Hallström H, Jansson H, Knutsson K. Different treatment strategies are applied to patients with the same periodontal status in general dentistry. Acta Odontol Scand 2014; 72:290-7. [PMID: 24053366 DOI: 10.3109/00016357.2013.824605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To analyse how general dental practitioners (GDPs) and dental hygienists judge and plan to treat patients with different periodontal conditions. MATERIALS AND METHODS Seventy-seven GDPs and 50 dental hygienists in a Swedish county, Halland, participated in a questionnaire study. The response rate was 94%. The questionnaire consisted of four simulated patient cases and an attached answer sheet. The patient cases had different periodontal status, ranging from healthy to moderate bone loss with general inflammation. The clinicians judged the periodontal status as healthy or diseased. If judged as diseased the clinicians suggested a diagnosis, selected treatment options and estimated the number of treatment sessions for each patient case. The clinicians were compared to each other regarding their judgement, as healthy or diseased, diagnostics and treatment. RESULTS Three out of four patients were judged both as healthy and diseased by different clinicians. If judged as diseased the patients were diagnosed as having gingivitis or periodontitis. Regardless of the clinicians' former judgement and diagnostics there were no differences (p > 0.05) in the selected treatment options but there was a difference (p < 0.05) in the suggested number of treatment sessions. CONCLUSIONS Clinicians' judgement of the same periodontal condition, as healthy or diseased, varies, which partly results in different treatment decisions considering the number of treatment sessions. The suggested number of treatment sessions varied also between clinicians even if they judged and diagnosed the condition likewise. The willingness to treat and suggested treatment options were not influenced by the variation in judgement and diagnostics.
Collapse
|
14
|
Liu KZ, Duarte PM, Santos VR, Xiang X, Xu M, Miranda TS, Fermiano D, Gonçalves TED, Sowa MG. Assessment of tissue oxygenation of periodontal inflammation in smokers using optical spectroscopy. J Clin Periodontol 2014; 41:340-7. [DOI: 10.1111/jcpe.12225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Kan-Zhi Liu
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
- Department of Dental Diagnostics and Surgical Sciences; University of Manitoba; Winnipeg Canada
| | - Poliana Mendes Duarte
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | - Vanessa Renata Santos
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | - Xiaoming Xiang
- Department of Dental Diagnostics and Surgical Sciences; University of Manitoba; Winnipeg Canada
| | - Minqi Xu
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
| | | | - Daiane Fermiano
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos Brazil
| | | | - Micheal G. Sowa
- Medical Devices Portfolio; National Research Council of Canada; Winnipeg Canada
| |
Collapse
|
15
|
Pejcic A, Zivkovic V, Bajagic V, Mirkovic D. Histological changes of gingival epithelium in smokers and non-smokers. Open Med (Wars) 2012; 7:756-60. [DOI: 10.2478/s11536-012-0050-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Collapse
|
16
|
Sreedevi M, Ramesh A, Dwarakanath C. Periodontal status in smokers and nonsmokers: a clinical, microbiological, and histopathological study. Int J Dent 2012; 2012:571590. [PMID: 22505904 DOI: 10.1155/2012/571590] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Accepted: 10/21/2011] [Indexed: 11/17/2022] Open
Abstract
A case-control study was done to assess the influence of smoking on clinical, microbiological, and histopathological parameters. Methods. Two hundred dentate male patients (100 smokers and 100 nonsmokers) ranging between 25 and 50 years were enrolled in the study. Periodontal parameters were recorded. Plaque samples were collected for microbial analysis for BANA test. Gingival biopsies were obtained from selected site for assessing histopathological changes. Results. Both groups showed almost similar plaque levels (P=0.258), but smokers had reduced gingival (0.62 ± 0.31) and bleeding indices (28.53 ± 17.52) and an increased calculus index (1.62 ± 0.36). Smokers had an increased probing depth of 4-7 mm (P=0.009) and overall increased CAL. No difference in microbiota was found between the two groups. Histopathologically smokers showed a decreased blood vessel density (8.84 ± 0.96) and inflammatory cells (52.00 ± 9.79). Conclusions. It is quite possible that many of the pathogenic mechanisms involved in tissue degradation in periodontitis in smokers could be quite different from those in nonsmokers.
Collapse
|
17
|
Rosa EF, Corraini P, de Carvalho VF, Inoue G, Gomes EF, Lotufo JPB, De Micheli G, Pannuti CM. A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters. J Clin Periodontol 2011; 38:562-71. [DOI: 10.1111/j.1600-051x.2011.01723.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
18
|
Sakallıoğlu EE, Lütfioğlu M, Sakallıoğlu U, Dıraman E, Pamuk F, Odyakmaz S. Local Peptidergic Innervation of Gingiva in Smoking and Non-Smoking Periodontitis Patients. J Periodontol 2008; 79:1451-6. [DOI: 10.1902/jop.2008.070667] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
19
|
Fisher S, Kells L, Picard JP, Gelskey SC, Singer DL, Lix L, Scott DA. Progression of Periodontal Disease in a Maintenance Population of Smokers and Non-Smokers: A 3-Year Longitudinal Study. J Periodontol 2008; 79:461-8. [DOI: 10.1902/jop.2008.070296] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
20
|
Abstract
AIM To investigate, by means of multilevel analysis, factors that may affect the short-term clinical outcome of non-surgical periodontal treatment. MATERIALS AND METHODS Forty-one patients randomly assigned to two protocols of non-surgical therapy were included. The impact of different covariates on the probability of "pocket closure" [i.e. probing pocket depth (PPD)<or=4 mm] was explored using a logistic multilevel model. The impact on the final PPD was explored using a continuous multilevel model. RESULTS The logistic model revealed a significant impact of smoking (p<0.001), presence of plaque at the site (p<0.001) and location of the pocket at a multi-rooted tooth (p<0.001). The model explained 44% of the total variability. Of the unexplained variance, 19% was attributed to inter-patient variability. The continuous model revealed the same factors to be significant and an additional significant impact of interactions between the covariates. The R(2) was 0.50 and the random slopes model revealed an increase in the variability of the final pocket depth with an increase in the initial PPD. CONCLUSION Smoking habits, plaque at site level and tooth type were significant factors in determining the short-term clinical outcome of non-surgical periodontal treatment.
Collapse
Affiliation(s)
- Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at Göteborg University, Sweden.
| | | | | |
Collapse
|
21
|
Hughes FJ, Syed M, Koshy B, Bostanci N, McKay IJ, Curtis MA, Marcenes W, Croucher RE. Prognostic factors in the treatment of generalized aggressive periodontitis: II. Effects of smoking on initial outcome. J Clin Periodontol 2006; 33:671-6. [PMID: 16856898 DOI: 10.1111/j.1600-051x.2006.00965.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS 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.
Collapse
Affiliation(s)
- Francis J Hughes
- Collaborative Group in Risk Factors for Periodontal Disease, Centre for Adult Oral Health, Institute of Dentistry, London, UK.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Gingivitis is a reversible inflammatory disease of the periodontal tissues. Periodontitis, in addition, involves destruction of the supporting structures of teeth. Diagnoses of gingivitis and periodontitis are predominantly dependent on clinical measurements of key inflammatory indices. Smokers are more susceptible to developing periodontal diseases, yet smoking masks overt signs of inflammation, presenting dental professionals with a clinical conundrum. We review the evidence that tobacco smoke may (i) cause acute periodontal vasoconstriction, (ii) inhibit periodontal angiogenesis in response to inflammatory stimuli, and/or (iii) suppress the production of pro-inflammatory mediators. It is clear that the mechanisms by which cigarette smoking dampens the periodontal inflammatory response are not yet fully understood. Further research into inflammatory suppression is warranted and should point to improved methods of diagnosis, not only in smokers, but also in non-smokers.
Collapse
Affiliation(s)
- D A Scott
- Department of Oral Biology, University of Manitoba, Manitoba Institute of Child Health, Canada.
| | | |
Collapse
|
23
|
Abstract
Epidemiological investigations support a firm relationship between smoking and periodontal disease. The likely benefits of smoking cessation programmes are considerable for periodontal disease, cancers and nearly all chronic systemic diseases. The mechanisms by which smoking may influence the development and progression of periodontal disease are as yet unclear, but may include changes in the vasculature, the immune and inflammatory systems, tissue oxygenation and the healing processes. Unfortunately, although dental professionals have more opportunities to encourage smokers to quit (most people visit their dentist more frequently than their doctor), dentists claim that they are not well informed on this subject. The purpose of this review is to describe the evidence for a link between smoking and periodontal disease, the possible pathology induced by smoking on the periodontal tissues and its impact on therapy, and to outline the smoking cessation techniques that are currently available.
Collapse
Affiliation(s)
- K K Hilgers
- Oral Health and Systemic Disease Research Group, University of Louisville School of Dentistry, Louisville, KY 40209, USA.
| | | |
Collapse
|
24
|
|
25
|
Affiliation(s)
- Andrea Mombelli
- Department of Periodontology and Oral Pathophysiology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
26
|
Razali M, Palmer RM, Coward P, Wilson RF. A retrospective study of periodontal disease severity in smokers and non-smokers. Br Dent J 2005; 198:495-8; discussion 485. [PMID: 15849588 DOI: 10.1038/sj.bdj.4812253] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2004] [Accepted: 04/07/2004] [Indexed: 11/09/2022]
Abstract
BACKGROUND Smoking has been associated with increased risk of periodontitis. The aim of the present study was to compare the periodontal disease severity of adult heavy smokers and never-smokers referred for assessment and treatment of chronic periodontitis. METHODS A random sample of patients with at least 20 teeth, stratified for smoking and age (5-year blocks, 35 to 55 years), was selected from an original referral population of 1,221 subjects with chronic adult periodontitis. Adequate records for 59 never-smokers and 44 subjects who smoked at least 20 cigarettes per day were retrieved. The percentage of alveolar bone support was measured from dental panoramic radiographs with a Schei ruler at x3 magnification with the examiner unaware of the smoking status. Probing depths at six sites per tooth were obtained from the initial consultation. RESULTS There was no significant difference in age between groups. Smokers had fewer teeth (p<0.001), fewer shallow pockets (p<0.001) and more deep probing depths (p<0.001). The differences were greater in subjects 45 years of age and over. In this age group, smokers had approximately 13% more bone loss, 15% more pockets in the 4-6 mm category and 7% more pockets in the >/= 7 mm category than the never-smokers. CONCLUSIONS This study confirmed that smokers had evidence of more severe periodontal disease than never-smokers. The differences increased with age confirming an exposure-related response.
Collapse
Affiliation(s)
- M Razali
- Dental Faculty, Universiti Kebangsaan Malaysia, Kuala Lumpur
| | | | | | | |
Collapse
|
27
|
Abstract
OBJECTIVES To evaluate longitudinally the effect of smoking cessation on clinical and radiographic outcomes following non-surgical treatment in smokers with chronic periodontitis. MATERIAL AND METHODS Forty-nine smokers with chronic periodontitis who wished to quit smoking were recruited. Full-mouth probing depths, bleeding and plaque data were recorded at baseline, 3, 6 and 12 months. Clinical attachment levels were recorded at target sites and subtraction radiography was used to assess bone density changes. Patients received non-surgical periodontal therapy during the first 3 months and supportive periodontal care over the remainder of the study. Smoking cessation counselling was provided according to individual need. RESULTS After 12 months, of patients with complete data, 10 had continuously quit smoking (20% of the original population), 10 continued smoking and six were oscillators (those patients who quit and then relapsed). There were no differences between the groups following treatment with respect to mean clinical or radiographic parameters. Analysis of probing depth reductions between baseline and month 12, however, and comparing quitters with the other two groups combined, demonstrated a significant difference in favour of quitters (p<0.05). Furthermore, quitters were significantly more likely to demonstrate probing depth reductions > or =2 and > or =3 mm than non-quitters and oscillators (p<0.05). CONCLUSION Quitting smoking has an additional beneficial effect in reducing probing depths following non-surgical treatment over a 12-month period.
Collapse
Affiliation(s)
- P M Preshaw
- School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | | | | | | | | | | |
Collapse
|
28
|
Abstract
AIMS In the search for an accurate periodontal probe which does not frequently penetrate the pocket base, a new tip has been designed which is flattened, and of 1 mm width and 0.45 mm thickness. This study aimed to evaluate the physico-mechanical and clinical properties of this probe (test) in comparison to a conventional 0.5 mm circular probe (control). METHODS Photoelastic stress analysis was undertaken for test and control probe tips at 3.15 and 5 N loads. To assess probing validity, the clinical probing depth with each probe (0.25 N force) at 125 sites on 27 teeth (27 subjects), was compared with the post-extraction connective tissue level measurement. Also evaluated were probing reproducibility (1200 sites in 25 subjects) and patient comfort (30 subjects). RESULTS Using photoelastic stress analysis, the test probe demonstrated lower stresses and less local stress concentration than the control. Clinically, the test probe measured close to the post-extraction gold standard in greater frequency than the control - 26 versus 11 readings (21% versus 9%) exactly matched, and 90 versus 67 (72% versus 54%) were within +/-0.5 mm of the laboratory measurement. The test probe was, on average, 0.13 mm coronal to the connective tissue attachment level, whereas the control penetrated 0.27 mm past this level. The intraclass correlation between clinical and laboratory readings was greater for the test than the control (r=0.81 and 0.74, respectively). Although the control probe overestimated probing depth more markedly at bleeding (0.41 mm) than at non-bleeding (0.15 mm) sites, the relative position of the test probe hardly differed with inflammatory status (-0.11 and -0.14 mm, respectively). Each probe demonstrated good clinical reproducibility. However, the test probe examination was more comfortable for the patient. CONCLUSION This new periodontal probe tip appears to have greater validity, good reproducibility and produces less patient discomfort.
Collapse
Affiliation(s)
- S R Vartoukian
- Department of Periodontology, GKT, Guy's Hospital, London, UK
| | | | | |
Collapse
|
29
|
Abstract
OBJECTIVE The outcome of non-surgical periodontal therapy is known to be inferior in smokers compared to non-smokers. In the present study, the question was asked whether such a difference in healing response may be less evident following adjunctive use of locally delivered controlled-release doxycycline. METHODS One hundred and three patients (42 smokers, 61 non-smokers), each having at least eight periodontal sites with PPD (probing pocket depth) > or =5 mm, were following stratification for smoking randomly assigned to two different treatment protocols; non-surgical scaling/root planing (Control) or ultrasonic instrumentation+application of a 8.5% w/w doxycycline gel (Atridox trade mark ) (Test). Instructions in oral hygiene were given to all patients. Clinical examinations of plaque, PPD, clinical attachment level (CAL) and bleeding following pocket probing were performed at baseline and after 3 months. Primary efficacy endpoints were changes in PPD and CAL. Patient mean values were calculated as basis for statistical analysis (multiple regression analyses). RESULTS The baseline examination revealed no significant difference in mean PPD between treatment groups or between smokers and non-smokers (mean PPD 5.7-5.9 mm). The mean PPD reduction in the control group at 3-month was 1.1 mm (SD=0.45) for smokers and 1.5 mm (0.67) for non-smokers. In the test group the PPD reduction was 1.4 mm (0.60) and 1.6 mm (0.45) for smokers and non-smokers, respectively. The mean CAL gain for smokers and non-smokers amounted to 0.5 mm (0.56) and 0.8 mm (0.71), respectively, in the control group, and to 0.8 mm (0.72) and 0.9 mm (0.82), respectively, in the test group. Multiple regression analysis revealed that smoking and initial PPD negatively influenced the treatment outcome in terms of PPD reduction and CAL gain, while the use of doxycycline had a significant positive effect. CONCLUSION Locally applied controlled-release doxycycline gel may partly counteract the negative effect of smoking on periodontal healing following non-surgical therapy.
Collapse
Affiliation(s)
- Cristiano Tomasi
- Department of Periodontology, Faculty of Odontology, The Sahlgrenska Academy at Göteborg University, Sweden
| | | |
Collapse
|
30
|
Petropoulos G, McKay IJ, Hughes FJ. The association between neutrophil numbers and interleukin-1alpha concentrations in gingival crevicular fluid of smokers and non-smokers with periodontal disease. J Clin Periodontol 2004; 31:390-5. [PMID: 15086622 DOI: 10.1111/j.1600-051x.2004.00489.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To test whether neutrophil numbers are directly correlated with interleukin-1alpha (IL-1alpha) concentrations in gingival crevicular fluid (GCF) of patients with periodontitis, and to investigate the effects of smoking on these parameters. MATERIALS AND METHODS A total of 99 GCF samples from 33 patients (14 smokers) suffering from severe chronic periodontitis were collected using Durapore filter strips. Polymorphonuclear leucocyte (PMN) numbers were counted using a Coulter cell counter and IL-1alpha levels were determined by ELISA. Total GCF protein was measured by Bio-Rad assay as a surrogate measure of GCF volume. RESULTS Mean IL-1alpha concentrations were significantly reduced in smokers compared with non-smokers (non-smokers: 3.29+/-2.02 pg/microg protein, smokers 1.59+/-1.13 pg/microg protein). There was no association between PMN numbers and IL-1alpha concentrations found when analysed either by site or by patient. PMN numbers were not significantly different between the two groups (non-smokers: 1.16 x 10(6)+/-1.04 x 10(6); smokers: 7.30 x 10(5)+/-8.07 x 10(5)). Smoking did not affect mean total protein concentration of samples. CONCLUSIONS Smoking significantly decreased IL-1alpha concentrations in GCF without affecting GCF volume sampled. The lack of association between IL-1alpha concentration and neutrophil numbers suggests that the reduced IL-1alpha concentrations seen in smokers is independent of any possible effect of smoking on neutrophil chemotaxis, and further suggests that smoking may directly inhibit IL-1alpha production.
Collapse
Affiliation(s)
- Georgios Petropoulos
- Department of Adult Oral Health, Barts and The London, Queen Mary's School of Medicine and Dentistry, Turner Street, London E1 2AD, UK
| | | | | |
Collapse
|
31
|
Van der Velden U, Varoufaki A, Hutter JW, Xu L, Timmerman MF, Van Winkelhoff AJ, Loos BG. Effect of smoking and periodontal treatment on the subgingival microflora. J Clin Periodontol 2003; 30:603-10. [PMID: 12834497 DOI: 10.1034/j.1600-051x.2003.00080.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The effect of smoking on the prevalence of periodontal pathogens after periodontal treatment is still not clear. Some studies found no effect of the smoking status on the prevalence of periodontal pathogens after therapy, whereas others did. The aim of this retrospective study was to investigate the influence of smoking on the treatment of periodontitis and the composition of the subgingival microflora. METHOD The study included 59 periodontitis patients (mean age 41.5 years): 30 smokers and 29 nonsmokers. The treatment consisted of initial periodontal therapy and, if necessary, surgery and/or antibiotics. Clinical and microbiological data were obtained before and after treatment at the deepest site in each quadrant. A pooled sample was analysed for the presence of Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotalla intermedia (Pi), Bacteroides forsythus (Bf), Fusobacterium nucleatum (Fn) and Peptostreptococcus micros (Pm). RESULTS For smokers and nonsmokers a significant improvement of the clinical condition was found after treatment. A decrease could be assessed for bleeding on probing (smokers: 0.46; nonsmokers: 0.52) and probing pocket depth (PPD) (smokers: 1.64 mm; nonsmokers: 2.09 mm). Furthermore, both groups showed gain of attachment (smokers: 0.68 mm; nonsmokers: 1.46 mm). No significant difference in bleeding on probing and PPD reduction was found between smokers and nonsmokers. In contrast, nonsmokers showed significantly more gain of attachment than smokers. The microbiological results revealed no differences in the prevalence of the various bacteria between smokers and nonsmokers before treatment. After treatment in nonsmokers, a significant decrease was found in the prevalence of Aa (11-3), Pg (17-7), Pi (27-11), Bf (27-11), Fn (28-20) and Pm (27-17). In smokers, a significant decrease could be shown only for the prevalence of Pg (15-5). CONCLUSIONS Nonsmokers showed more gain of attachment and a greater decrease in the prevalence of periodontal bacteria as compared to smokers. The phenomenon that among smokers, more patients remain culture positive for periodontal pathogens after therapy, may contribute to the often observed unfavourable treatment results in smoker periodontitis patients.
Collapse
Affiliation(s)
- U Van der Velden
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|