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Apatzidou DA. The role of cigarette smoking in periodontal disease and treatment outcomes of dental implant therapy. Periodontol 2000 2022; 90:45-61. [PMID: 35950749 DOI: 10.1111/prd.12449] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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.
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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
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Salhi L, Lambert F, Seidel L, Albert A. Predicting probing depth reduction after periodontal non-surgical treatment in smokers according to the nicotine dependence and the number of cigarette consumed. Heliyon 2022; 8:e10143. [PMID: 36039129 PMCID: PMC9418199 DOI: 10.1016/j.heliyon.2022.e10143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/08/2022] [Accepted: 07/27/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Smoking is considered as a risk factor for the poor outcomes after periodontitis non-surgical treatment (PNST). The aim of this short communication is to predict probing depth reduction after periodontal non-surgical treatment in smokers according to the nicotine dependence (FTND) and the number of cigarette consumed (NCC). Methods This work is a post-hoc study of a prospective controlled study on the effect of oral hygiene instructions and PNST on periodontal outcomes. This short communication focused only on the current conventional smokers (N = 34), based on specific smoking indicators, and on probing depth (PD) parameter that were recorded at baseline (time 0), after oral hygiene instruction (time 1) and 3 months after PNST (time 2). Results The 34 smokers had a mean age 46.5 ± 11.5 years. The NCC- and FTND-based predictions allowed to show in a specific nomogram the PD values 3 months after PNST for each NCC and FTND category. Conclusion Two nomograms are proposed for prognostic purposes and allow patients to understand the impact of smoking on periodontitis according to the number of cigarette consumed and the level of nicotine dependence. These nomograms might be also used for supporting smoking cessation. Clinical significance In smoker patients with periodontitis, there is a need to predict, for both patient and clinicians, the impact of the number of cigarettes consumed and the level of nicotine dependence on probing depth after oral hygiene instructions and debridement. Two nomograms are proposed for prognostic purposes.
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Kanmaz M, Kanmaz B, Buduneli N. Periodontal treatment outcomes in smokers: A narrative review. Tob Induc Dis 2021; 19:77. [PMID: 34707470 PMCID: PMC8494073 DOI: 10.18332/tid/142106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/19/2021] [Accepted: 09/09/2021] [Indexed: 01/01/2023] Open
Abstract
Smoking is considered as the major environmental risk factor for periodontal diseases. Smokers have a higher risk for severe periodontitis with more periodontal tissue destruction, more gingival recession, and more susceptibility for tooth loss. The aim of this narrative review is to provide up-to-date evidence on the clinical outcomes of periodontal treatment in smokers. Electronic databases were searched for studies that compare the clinical outcomes in smokers and non-smokers following non-surgical and surgical periodontal treatment modalities and also during the supportive periodontal treatment. Clinical studies published before May 2021 were included in the review. Smokers have a higher risk for recurrence of periodontal disease and the response to non-surgical as well as surgical periodontal treatment is not as good as that of non-smokers. Moreover, there is a dose-response effect in the adverse effects of smoking on periodontal health. Compared to non-smokers, smoker patients with periodontitis tend to respond less favorably to non-surgical and surgical periodontal treatment, and exhibit recurrence more frequently during supportive periodontal treatment. Along with the periodontal treatment, smokers may be encouraged to quit. Long follow-up and the communication between the dentist and the patient give a great opportunity for such counseling.
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Affiliation(s)
- Mehmet Kanmaz
- Department of Periodontology, Faculty of Dentistry, Izmir Tınaztepe University, Izmir, Turkey
| | - Burcu Kanmaz
- Department of Periodontology, Faculty of Dentistry, Izmir University of Democracy, Izmir, Turkey
| | - Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
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Ahad A, Bey A, Khan S, Ahmad MS. Periodontal status associated with dual habits of smoking and smokeless tobacco use: A cross-sectional study in young adults. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2021; 13:69-75. [PMID: 35919680 PMCID: PMC9327479 DOI: 10.34172/japid.2021.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/09/2021] [Indexed: 11/09/2022]
Abstract
Background. Tobacco smoke is an established risk factor for periodontitis. However, few studies have evaluated the periodontal status of smokeless tobacco (SLT) users, while that of individuals with dual habits has largely been unexplored. Therefore, the current study aimed to find if the periodontal status in individuals with dual habits of smoking and SLT use is different from those with any single habit.Methods. Four groups (A: exclusive smokers, B: exclusive tobacco chewers, C: individuals with dual habits, and D: non-users of tobacco), each comprising 75 males in the age group of 20 to 35 years, were selected. Along with the history of tobacco use, a modified oral hygiene index (OHI), gingival index (GI), probing depth (PD), and the number of teeth with gingival recession (GR) were recorded. The data were assessed using the Chi-squared test, one-way ANOVA, and logistic regression. Statistical significance was set at P<0.05.Results. Group C exhibited the highest mean OHI scores, with 94.66% of participants having poor oral hygiene (OHI>3.0). The prevalence of severe gingivitis (GI>2.0) was significantly lower among exclusive smokers (group A) and those with dual habits (group C) compared to the other two groups. As much as 60% of group C participants had average PD in the range of 4-6 mm, while deeper average PD (>6 mm) was most common among smokers. The highest risk of having a tooth with GR was also associated with the dual habit (OR = 4.33, 95% CI = 3.24 - 5.76) compared with the non-users.Conclusion. While both forms of tobacco were associated with poor periodontal status, the additive effect of smoking and SLT use was evident in almost all the parameters, more so with poor oral hygiene and the prevalence of gingival recession. These findings emphasize that individuals with dual habits have an additional risk for periodontal destruction.
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Affiliation(s)
- Abdul Ahad
- Department of Dentistry, Medini Rai Medical College, Palamu, Jharkhand, India
| | - Afshan Bey
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Saif Khan
- Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Mohammad Sami Ahmad
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Madinah, Saudi Arabia
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Schoenmakers MGP, Willems EJS, Slot DE, Van der Weijden GAF. Success of supportive periodontal therapy in periodontitis patients - A retrospective analysis. Int J Dent Hyg 2021; 20:318-327. [PMID: 34013646 PMCID: PMC9292265 DOI: 10.1111/idh.12521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 04/09/2021] [Accepted: 05/14/2021] [Indexed: 11/28/2022]
Abstract
Objective The aim of this retrospective analysis was to evaluate, in adult patients treated for periodontitis, the periodontal stability during supportive periodontal therapy (SPT). Methods Data were collected and analyzed retrospectively for periodontitis patients aged ≥36 years who underwent active periodontal therapy (APT) and were following an SPT programme. The stability of the APT success, defined as a probing pocket depth (PPD) of ≤5 mm, was the main outcome parameter. Analyses were performed in which PPD, tooth loss (TL), bleeding on probing (BOP), periodontal epithelium surface area (PESA), and the effects of age, gender, smoking status, and the number of years in SPT were evaluated. The annual TL and BOP of <10% in addition to a PPD of ≤5 mm were considered to be secondary outcome variables. Results In total, 993 patients were included, in 36% of whom a PPD ≤5 mm was found at the evaluation of APT. If the outcome was defined as a BOP of <10% in addition to a PPD of ≤5 mm, this was present in only 16% of the patients. During SPT, a small overall increase in clinical parameters for the total population and an annual average TL of 0.15 per patient was observed. Patients of male gender and smokers negatively affected the success of SPT. Conclusion The periodontal clinical status remained ‘fairly’ stable during SPT in chronic periodontitis patients aged ≥36 years. Smoking negatively affects the outcome of APT and periodontal stability during SPT.
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Affiliation(s)
- Max G P Schoenmakers
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eveline J S Willems
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G A Fridus Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinic for Periodontology, Utrecht, The Netherlands
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Salhi L, Seidel L, Albert A, Lambert F. Fagerström test for nicotine dependence as an indicator in tobacco-related studies in periodontology. J Periodontol 2021; 92:298-305. [PMID: 33480446 DOI: 10.1002/jper.20-0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Smoking is considered a risk factor for periodontitis genesis and progression. Numerous clinical studies have demonstrated the negative effect of smoking, in particular the number of cigarettes consumed (NCC), on periodontal clinical parameters. However, smoking addiction assessed by the Fagerström test for nicotine dependence (FTND) has received little attention in periodontal research. METHODS In smoking patients presenting with periodontitis, the periodontal clinical features were measured and correlated with smoking status. The ability of FTND and NCC to predict periodontitis severity was assessed and compared. RESULTS Thirty-four smoking patients aged 46.5 ± 11.5 years were included. The means of NCC and FTND were 16.6 ± 5.5 and 5.2 ±1.8, respectively. NCC and FTND were correlated with each other (r = 0.57, P < 0.001). Patients had stage III (44.1%) or stage IV (55.9%) periodontitis and 73.5% presented a generalized extension of periodontitis. The combination of FTND and NCC in discerning disease severity (ROC curve analysis: AUC = 0.746, P = 0.027) was superior to each indicator separately. A discriminant score based on both indicators (D = -0.42 - 0.15 × NCC + 0.63 × FTND) derived by logistic regression showed the opposite role of the indicators and the greater relevance of FTND (P = 0.031) compared to NCC (P = 0.084) in the relationship. CONCLUSION This study shows that FTND could substantially complement NCC as an indicator of smoking status in periodontal research.
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Affiliation(s)
- Leila Salhi
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liege, Belgium
| | - Laurence Seidel
- Department of Biostatistics, University Hospital, University of Liège, Liege, Belgium
| | - Adelin Albert
- Department of Public Health Sciences, University of Liège, Liege, Belgium
| | - France Lambert
- Dental Biomaterials Research Unit, Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liege, Belgium
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Chang J, Meng HW, Lalla E, Lee CT. The impact of smoking on non-surgical periodontal therapy: A systematic review and meta-analysis. J Clin Periodontol 2020; 48:60-75. [PMID: 33022758 DOI: 10.1111/jcpe.13384] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/17/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
AIM Smoking is a risk factor for periodontitis. This study aimed to evaluate the impact of smoking on clinical outcomes of non-surgical periodontal therapy. MATERIALS AND METHODS Electronic databases were searched to screen studies published before May 2020. The included studies had to have two groups: smokers (S) and non-smokers (NS) with periodontitis. The outcomes evaluated were differences between groups in probing depth (PD) reduction and clinical attachment level (CAL) gain after non-surgical periodontal therapy. Meta-regressions were conducted to evaluate correlations between outcomes and other contributing factors. RESULTS Seventeen studies were included. The post-treatment PD reduction in the S group was smaller than in the NS group (weighted mean difference in PD reduction: -0.33 mm, 95% confidence interval (CI): [-0.49, -0.17], p < .01). The CAL gain in the S group was also smaller than in the NS group (weighted mean difference in CAL gain: -0.20 mm, CI: [-0.39, -0.02], p < .01). Additionally, baseline PD significantly affected the difference in PD reduction between two groups. CONCLUSIONS Smoking negatively impacts clinical responses to non-surgical periodontal therapy. Smokers with periodontitis have significantly less PD reduction and CAL gain than non-smokers.
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Affiliation(s)
- Jennifer Chang
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA
| | - Hsiu-Wan Meng
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA
| | - Evanthia Lalla
- Division of Periodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA
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Li A, Chen Y, van der Sluis LWM, Schuller AA, Tjakkes GH. White Blood Cell Count Mediates the Association Between Periodontal Inflammation and Cognitive Performance Measured by Digit Symbol Substitution Test Among Older U.S. Adults. J Gerontol A Biol Sci Med Sci 2020; 76:1309-1315. [DOI: 10.1093/gerona/glaa223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Systemic effects of periodontal infection may increase the risk of central neuroinflammation, aggravating impaired cognition. This study aims to examine whether systemic inflammatory factors mediate the possible association between periodontal inflammation and cognitive function.
Methods
We conducted a cross-sectional analysis of 766 participants aged ≥ 60 years and who had completed periodontal and cognitive examinations in the National Health and Nutrition Examination Survey (NHANES) 2001–2002. We used multivariable linear regression to investigate the overall association between periodontal health and cognitive function as measured by the digit symbol substitution test (DSST). Bleeding on probing (BOP) and periodontal inflamed surface area (PISA) were used to assess the periodontal inflammatory activity and burden, respectively. Mediation analyses were used to test the indirect effects of the BOP/PISA on DSST via C-reactive protein, white blood cell (WBC) count, and fibrinogen.
Results
Participants with superior periodontal health obtained higher DSST scores than those with poorer periodontal health, adjusting for demographic factors and chronic conditions. Concerning the inflammatory activity, WBC count acted as a full mediator in the association between BOP and DSST (β = −0.091; 95% confidence interval [CI] = −0.174 to −0.008) and mediated 27.5% of the total association. Regarding the inflammatory burden, WBC count acted as a partial mediator in the association between PISA and DSST (β = −0.059; 95% CI = −0.087 to −0.031) and mediated 20.3% of the total association.
Conclusion
Our study indicated the potential role of systemic inflammatory factors as a mediator of associations between periodontal inflammation and cognitive function in the U.S. geriatric population.
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Affiliation(s)
- An Li
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Yuntao Chen
- Medical Statistics and Decision Making, Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Luc W M van der Sluis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
- Department of Child Health, the Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Geerten-Has Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
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Salhi L, Albert A, Seidel L, Lambert F. Respective Effects of Oral Hygiene Instructions and Periodontal Nonsurgical Treatment (Debridement) on Clinical Parameters and Patient-Reported Outcome Measures with Respect to Smoking. J Clin Med 2020; 9:E2491. [PMID: 32756385 PMCID: PMC7464916 DOI: 10.3390/jcm9082491] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Oral hygiene instructions (OHI) and periodontal nonsurgical treatment (PNST) play pivotal roles in the management of periodontitis. The study aims to discern their respective effects on periodontal clinical parameters and patient-reported outcome measures (PROMs). METHODS Ninety-one patients were included, 34 non-smokers (NS), 25 former smokers (FS) and 32 current smoker (CS). Clinical parameters such as probing depth (PD) and bleeding on probing (BOP) were collected, and the periodontal inflamed tissue area (PISA) was calculated. Clinical parameters and PROMs were recorded before and after receiving OHI, with electronic tooth brush and interdental brushes, as well as 3 months after debridement. RESULTS Smokers presented a significantly higher proportion of severe periodontitis (64.7%) with generalized extension (76.5%) and with a rapid rate of progression (97.1%) compared to NS and FS. OHI led to a significant decrease of PD, BOP, and PISA (p < 0.0001) only in NS and FS. Debridement reduced PD and the percentage of PD >6 mm in all groups (p < 0.0001). OHI induced significant improvement of oral hygiene, frequency of interdental cleaning, and PROMs (p < 0.0001). Further debridement induced significant additional improvement PROMs in FS and NS (p < 0.0001). CONCLUSION OHI and debridement improved periodontal clinical parameters and PROMs in both NS and FS. Former smokers had comparable outcomes to non-smokers, suggesting that smoking cessation should be encouraged.
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Affiliation(s)
- Leila Salhi
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, 4000 Liège, Belgium
| | - Adelin Albert
- Department of Public Health Sciences, University of Liège, 4000 Liège, Belgium;
| | - Laurence Seidel
- Department of Biostatistics and Medico-economic information, University of Liège, 4000 Liège, Belgium;
| | - France Lambert
- Dental Biomaterials Research Unit, Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, 4000 Liège, Belgium;
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Amaranath BJ, Das N, Gupta I, Gupta R, John B, Devi MP. Types of bone destruction and its severity in chronic periodontitis patients with tobacco smoking habit using periapical radiographs and transgingival probing: A cross-sectional study. J Indian Soc Periodontol 2019; 24:20-25. [PMID: 31983840 PMCID: PMC6961448 DOI: 10.4103/jisp.jisp_212_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/16/2019] [Accepted: 06/24/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Tobacco smoking is an independent risk factor for periodontal disease which increases periodontal pocketing, attachment loss, as well as bone loss leading to varied severity and bone destruction in the form of horizontal and vertical patterns. Aim: The aim of the present study is to determine and measure the types and severity of bone destruction in chronic periodontitis (CP) patients with tobacco smoking habit using intraoral periapical (IOPA) radiographs and transgingival probing. Materials and Methods: A total of 60 male participants with CP were included in the study. Group A comprised 30 heavy cigarette smokers and Group B comprised 30 nonsmokers. Clinical parameters such as plaque index (PI), probing pocket depth (PPD), and clinical attachment loss (CAL) were recorded. Amount and pattern of bone loss were assessed using IOPA and transgingival probing. Results: The mean values of PI, PPD, and CAL were 2.50 ± 0.28 mm, 9.33 ± 1.42 mm, and 10.2 ± 1.62 mm, respectively, for cigarette smokers, which were found to be higher and statistically significant as compared to nonsmokers. Cigarette smokers showed more bone destruction than nonsmokers in respect to maxillary molars 4.42 ± 1.31 mm and incisors 3.90 ± 1.10 mm as compared to nonsmokers. Types of bone destruction were more of vertical patterns (93.3%) in cigarette smokers. Conclusions: Tobacco smoking was associated with severe attachment loss. Tobacco smoking not only affects soft tissues but also hard tissues such as bone. Palatal sides of maxillary molars showed significantly higher bone loss and also had more percentage of vertical patterns of bone loss compared to nonsmokers. IOPA and transgingival probing may be used as noninvasive methods for the determination of types and severity of bone destruction in CP patients with or without tobacco smoking habit.
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Affiliation(s)
- Bj Janardhana Amaranath
- Department of Periodontology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Neelam Das
- Department of Periodontology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Ira Gupta
- Department of Periodontology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Rohit Gupta
- Department of Periodontology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Bijoy John
- Department of Periodontology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Munishwar Parvathi Devi
- Department of Periodontology, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
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Velidandla S, Bodduru R, Birra V, Jain Y, Valluri R, Ealla KKR. Distribution of Periodontal Pockets Among Smokers and Nonsmokers in Patients with Chronic Periodontitis: A Cross-sectional Study. Cureus 2019; 11:e5586. [PMID: 31696005 PMCID: PMC6820887 DOI: 10.7759/cureus.5586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Context Cigarette smoking is a well-established risk factor for periodontitis and carries an increased risk for loss of periodontal attachment as well as bone loss. Aims The purpose of the present study was to investigate whether disease severity differs between smokers and nonsmokers in a group of chronic periodontitis patients by assessing the periodontal probing depth (PPD) and bleeding on probing (BOP). Materials and methods The study included 150 individuals, 75 smokers and 75 nonsmokers, in the age group of 35-60 years. Subjects with chronic periodontitis were selected and included in the study. Periodontal evaluation, including periodontal probing pocket depths and bleeding on probing, was performed on all four quadrants and at six sites per tooth using the Williams periodontal probe. The data were pooled from the anterior sextant and the posterior sextant as well as from the facial and lingual surfaces. Statistical analysis Comparisons were made between smokers and nonsmokers using the z-test (two-tailed test). Probing pocket depth categories 0-3 mm, 4-5 mm, 6-7 mm, and ≥8 mm and the proportion of sites having a pocket depth of ≥5 mm were used in the analysis. Results The mean percentage of sites that bleed upon probing was higher for nonsmokers as compared with smokers. Smokers had less shallow pockets (0-3 mm) than nonsmokers and more pockets of 4-7 mm (categories 4-5 mm, 6-7 mm). No significant differences were detected in the prevalence of pockets ≥8 mm. In the anterior, premolar, and molar regions, pockets of 6-7 mm were significantly more prevalent in smokers. The buccal and lingual sides also showed that smokers had more sites with deep probing depths ≥5 mm than nonsmokers. The data also showed that in the upper jaw, in the anterior and premolar teeth, the largest differences were found between smokers and nonsmokers. Conclusions From the results, it can be concluded that cigarette smoking results in periodontal tissue destruction in the different areas of the oral cavity, with the maximum periodontal destruction in the maxillary anterior and premolar region.
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Affiliation(s)
- Surekha Velidandla
- Oral and Maxillofacial Pathology, MNR Dental College and Hospital, Hyderabad, IND
| | | | - Vinod Birra
- Dentistry, Government Medical College, Srikakulam, IND
| | - Yash Jain
- General Dentistry, Malla Reddy Institute of Dental Sciences, Hyderabad, IND
| | - Rathna Valluri
- General Dentistry, Malla Reddy Institute of Dental Sciences, Hyderabad, IND
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Van der Weijden GAF, Dekkers GJ, Slot DE. Success of non-surgical periodontal therapy in adult periodontitis patients: A retrospective analysis. Int J Dent Hyg 2019; 17:309-317. [PMID: 30942938 PMCID: PMC6852011 DOI: 10.1111/idh.12399] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/26/2019] [Accepted: 03/29/2019] [Indexed: 01/02/2023]
Abstract
Objective To evaluate the results of active non‐surgical treatment in patients diagnosed with adult periodontitis treated in a specialized clinic for periodontology. Material & Methods In total, 1182 patients with adult periodontitis received active non‐surgical therapy, which involved professional oral hygiene instruction, scaling and root planing, supragingival polishing and elective systemic antimicrobial medication. The results of this therapy were based on a full‐mouth periodontal chart as assessed at the time of evaluation. Successful treatment as periodontal pocket depth (PPD) ≤5 mm was the main outcome parameter with bleeding on pocket probing as secondary outcome. Patient‐related factors such as smoking and severity of periodontitis at baseline and site‐related factors such as tooth type, furcation involvement and endodontic treatment were analysed. Possible relations with assessed parameters and the success of active periodontal therapy were evaluated. Results Overall 39% of the patients reached the successful treatment objective and a mean bleeding on pocket probing tendency of 14%. Treatment success appeared to be dependent on tooth type where the results at single‐rooted front teeth (85%) and premolar teeth (78%) were more successful than at molar teeth (47%). Analysis revealed that in 55% of the cases furcation involvement at molars was associated with the absence of success. Endodontic treatment was associated with absence of success in 8%‐11% of the cases. Smoking negatively influences successful treatment outcome (P < 0.001). Conclusion Active non‐surgical periodontal therapy in patients with adult periodontitis resulted in approximately one third of the cases in the success endpoint of PPD ≤ 5mm. Sub‐analysis showed that the outcome appeared to be dependent on tooth type, furcation involvement, severity of periodontal disease at intake and smoking status.
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Affiliation(s)
- G A Fridus Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinic for Periodontology Utrecht, Utrecht, The Netherlands
| | - Gijs J Dekkers
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Van Dijk LJ, Lie MA, Van den Heuvel ER, Van der Weijden GA. Adult periodontitis treated with a new device for subgingival lavage-a randomized controlled clinical trial using a split-mouth design. Int J Dent Hyg 2018; 16:559-568. [PMID: 29708654 DOI: 10.1111/idh.12344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate in patients with untreated adult periodontitis, the effect of treatment with a novel pocket irrigator/evacuator device (IED) compared to conventional subgingival debridement (CPT), both provided during the initial phase of active periodontal therapy. METHODS This study was an examiner-blind, randomized controlled clinical trial using a split-mouth design. Systemically healthy patients with adult periodontitis were selected. Full-mouth probing pocket depth (PPD), gingival bleeding on pocket probing scores (BOPP), gingival recession (REC) and dental plaque (PI) were assessed at baseline. All participants received oral hygiene instructions and supragingival prophylaxis including polishing. In 2 randomly assigned contra-lateral quadrants, approximal sites were irrigated with the IED, whereas in the other quadrants, CPT was provided. The CPT consisted of subgingival debridement using ultrasonic devices followed by the use of hand instruments. At 3 months post-treatment, the clinical parameters were re-assessed. RESULTS Twenty-five patients met the inclusion criteria and were willing to participate. At 3 months post-treatment, the PPD and BOPP had significantly improved for both treatment modalities. Pockets of ≥5 mm reduced by 0.64 mm in the IED group (P < .001), compared to a reduction of 0.82 mm for the CPT group (P < .001). With respect to the primary outcome parameter (PPD) and BI, the results with the IED were less pronounced. Between the test and control groups, no significant differences were observed for REC and PI. CONCLUSIONS Oral hygiene instructions, supragingival prophylaxis and subgingival lavage with the IED resulted in a significant reduction in PPD and BOPP. However, the effect does not reach the results of CPT which included the subgingival use of ultrasonic and hand instruments.
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Affiliation(s)
- L J Van Dijk
- Clinic for Periodontology, Groningen, The Netherlands
| | - M A Lie
- Clinic for Periodontology, Groningen, The Netherlands
| | - E R Van den Heuvel
- Department of Mathematics & Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - G A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.,Clinic for Periodontology & Implantology, Utrecht, The Netherlands
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Jacob V, Vellappally S, Šmejkalová J. The Influence of Cigarette Smoking on Various Aspects of Periodontal Health. ACTA MEDICA (HRADEC KRÁLOVÉ) 2018. [DOI: 10.14712/18059694.2017.52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Tobacco is one of the most important risk factors for oral diseases, including oral cancer, oral mucosal lesions and periodontal diseases. There is substantial evidence suggesting that the risk of oral diseases increases with frequent use of tobacco and that quitting smoking results in reduced risk. In this article, the influence of cigarette smoking on the periodontium will be discussed, giving importance to the effects on immune responses, alveolar bone loss, periodontal pathogens and briefly outlining the negative effects of smoking on wound healing and periodontal treatment procedures.
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De Wet LM, Slot DE, Van der Weijden GA. Supportive periodontal treatment: Pocket depth changes and tooth loss. Int J Dent Hyg 2017; 16:210-218. [DOI: 10.1111/idh.12290] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2017] [Indexed: 12/26/2022]
Affiliation(s)
- LM De Wet
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - DE Slot
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - GA Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
- Clinic for Periodontology Utrecht; Utrecht The Netherlands
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16
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Bunaes DF, Lie SA, Åstrøm AN, Mustafa K, Leknes KN. Site-specific treatment outcome in smokers following 12 months of supportive periodontal therapy. J Clin Periodontol 2016; 43:1086-1093. [PMID: 27554463 PMCID: PMC5132109 DOI: 10.1111/jcpe.12619] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2016] [Indexed: 12/05/2022]
Abstract
Aim To evaluate the effect of cigarette smoking on periodontal health at patient, tooth, and site levels following supportive therapy. Materials and Methods Eighty chronic periodontitis patients, 40 smokers and 40 non‐smokers, were recruited to a single‐arm clinical trial. Periodontal examinations were performed at baseline (T0), 3 months following active periodontal therapy (T1), and 12 months following supportive periodontal therapy (T2). Smoking status was validated measuring serum cotinine levels. Probing depth (PD) ≥ 5 mm with bleeding on probing (BoP) was defined as the primary outcome. Logistic regression analyses adjusted for clustered observations of patients, teeth, and sites and mixed effects models were employed to analyse the data. Results All clinical parameters improved from T0 to T2 (p < 0.001), whereas PD, bleeding index (BI), and plaque index (PI) increased from T1 to T2 in smokers and non‐smokers (p < 0.001). An overall negative effect of smoking was revealed at T2 (OR = 2.78, CI: 1.49, 5.18, p < 0.001), with the most pronounced effect at maxillary single‐rooted teeth (OR = 5.08, CI: 2.01, 12.78, p < 0.001). At the patient level, less variation in treatment outcome was detected within smokers (ICC = 0.137) compared with non‐smokers (ICC = 0.051). Conclusion Smoking has a negative effect on periodontal health following 12 months of supportive therapy, in particular at maxillary single‐rooted teeth.
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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
| | - Anne Nordrehaug Åstrøm
- 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
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Ziukaite L, Slot DE, Loos BG, Coucke W, Van der Weijden GA. Family history of periodontal disease and prevalence of smoking status among adult periodontitis patients: a cross-sectional study. Int J Dent Hyg 2016; 15:e28-e34. [DOI: 10.1111/idh.12224] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2016] [Indexed: 12/12/2022]
Affiliation(s)
- L Ziukaite
- Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - DE Slot
- Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - BG Loos
- Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | | | - GA Van der Weijden
- Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
- Clinic for Periodontology; Utrecht The Netherlands
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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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
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19
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Liu KH, Hwang SJ. Effect of smoking cessation for 1 year on periodontal biomarkers in gingival crevicular fluid. J Periodontal Res 2015; 51:366-75. [DOI: 10.1111/jre.12316] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2015] [Indexed: 12/12/2022]
Affiliation(s)
- K. H. Liu
- College of Pharmacy and Research Institute of Pharmaceutical Sciences; Kyungpook National University; Daegu South Korea
| | - S. J. Hwang
- Laboratory for Systems Biology and Bio-Inspired Engineering; Graduate School of Medical Science and Engineering; Korea Advanced Institute of Science and Technology (KAIST); Daejeon South Korea
- Department of Dental Hygiene; College of Medical Science; Konyang University; Daejeon South Korea
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Kanakdande V, Patil KP, Nayyar AS. Comparative Evaluation of Clinical, Hematological and Systemic Inflammatory Markers in Smokers and Non-Smokers with Chronic Periodontitis. Contemp Clin Dent 2015; 6:348-57. [PMID: 26321834 PMCID: PMC4549986 DOI: 10.4103/0976-237x.161885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Context: Systemic conditions, especially chronic infections, have a direct impact on the general health and well-being of an individual. Similarly, the long-standing inflammatory changes seen during periodontitis have been associated with the altered diabetic control, preterm, low birth weight infants, and cardiovascular disease. Being a low-grade infection, the signs may not be as severe as seen in other systemic conditions, but they definitely cannot be ignored. Aims: The present study was designed to compare clinical, hematological, and systemic inflammatory markers in patients with chronic periodontitis. Subjects and Methods: A total of 90 chronic periodontitis patients were selected for the present study from the outpatient department of the Department of Periodontology, and the various clinical and hematological parameters were then assessed. Statistical Analysis Used: Z-test was used to compare the probing depth, clinical attachment loss, hematological parameter, and interleukin-6 values between Group A and Group B. Mann–Whitney U-test was used to compare gingival index, plaque index, and bleeding on probing between Group A and Group B. Results: The results of the study were based on the comparison of the clinical, hematological, and systemic inflammatory markers in smokers and nonsmokers with chronic periodontitis and came out to be statistically highly significant. Conclusions: With the resurgence of emphasis on significance of oral diseases related to systemic health, the medical professionals also need to familiarize themselves with the oral cavity and the oral-systemic inter-relationships to treat or reduce the morbidity of the underlying medical condition. Furthermore, the oral health care professionals must reach out to the medical community and the general public to improve patient care through education and communication about the oral health-systemic health link.
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Affiliation(s)
- Vinayak Kanakdande
- Department of Periodontics and Oral Implantology, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Kaustubh P Patil
- Department of Periodontics and Oral Implantology, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Abhishek Singh Nayyar
- Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post Graduate Research Institute, Parbhani, Maharashtra, India
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Farina R, Tomasi C, Trombelli L. The bleeding site: a multi-level analysis of associated factors. J Clin Periodontol 2013; 40:735-42. [DOI: 10.1111/jcpe.12118] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
| | - Cristiano Tomasi
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
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Anand PS, Kamath KP, Bansal A, Dwivedi S, Anil S. Comparison of periodontal destruction patterns among patients with and without the habit of smokeless tobacco use - a retrospective study. J Periodontal Res 2013; 48:623-31. [DOI: 10.1111/jre.12048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2012] [Indexed: 11/29/2022]
Affiliation(s)
- P. S. Anand
- Department of Periodontics; People's College of Dental Sciences & Research Centre; Bhopal Madhya Pradesh State India
| | - K. P. Kamath
- Department of Oral Pathology; People's Dental Academy; Bhopal Madhya Pradesh State India
| | - A. Bansal
- Department of Periodontics; People's College of Dental Sciences & Research Centre; Bhopal Madhya Pradesh State India
| | - S. Dwivedi
- Department of Periodontics; People's College of Dental Sciences & Research Centre; Bhopal Madhya Pradesh State India
| | - S. Anil
- Department of Periodontics and Community Dentistry; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
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Kumar PS. Smoking and the subgingival ecosystem: a pathogen-enriched community. Future Microbiol 2013; 7:917-9. [PMID: 22913349 DOI: 10.2217/fmb.12.71] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Taichman LS, Sohn W, Kolenic G, Sowers M. Depot medroxyprogesterone acetate use and periodontal health in 15- to 44-year-old US females. J Periodontol 2012; 83:1008-17. [PMID: 22309173 DOI: 10.1902/jop.2012.110534] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND It has been suggested that progestins may have an inflammatory component and/or increase in prostaglandin synthesis. Thus, extended progestin use may be associated with higher risk of periodontal diseases. This study investigates the association between depot medroxyprogesterone acetate (DMPA) injectable contraception and the prevalence of periodontal diseases among US premenopausal females. METHODS Data for this cross-sectional analysis comes from the 1999 to 2004 National Health and Nutrition Examination Surveys. This analysis includes 4,460 US females (15 to 44 years of age) with complete DMPA usage and periodontal status data. RESULTS Current and past DMPA use was 4.1% and 12.0%, respectively. The prevalence of gingivitis was 53.9% for females who reported having used DMPA compared with 46.1% for DMPA never-users. Females taking DMPA were more likely to be young, single, and non-white, have a history of smoking, have lower levels of education and income, and have ≥1 live births and were less likely to visit the dentist. Using logistic regression, DMPA use was associated with an increased risk of gingivitis (odds ratio [OR] =1.7; 95% confidence interval [CI] = 1.09 to 1.67) and periodontitis (DMPA, OR = 1.49; 95% CI = 1.01 to 2.22) after adjusting for age, race, education, poverty income ratio, dental care use, and smoking status. A significant interaction between smoking status and DMPA use was also found (P = 0.029). CONCLUSIONS This study suggests that DMPA use may be associated with periodontal diseases. Additional investigation is warranted as a result of the disproportionate usage of DMPA among low-income populations who are at an increased risk for poor dental health.
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Affiliation(s)
- L Susan Taichman
- Department of Periodontics and Oral Medicine, Room 3345, University of Michigan School of Dentistry, 1011 N. University Ave., Ann Arbor, MI 48109-1078, USA.
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Torrungruang K, Gongsakdi V, Laohaviraphab L, Likittanasombat K, Ratanachaiwong W. Association between cigarette smoking and the intraoral distribution of periodontal disease in Thai men over 50 years of age. ACTA ACUST UNITED AC 2011; 3:135-41. [DOI: 10.1111/j.2041-1626.2011.00105.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Desjardins J, Grenier D. Neutralizing effect of green tea epigallocatechin-3-gallate on nicotine-induced toxicity and chemokine (C-C motif) ligand 5 secretion in human oral epithelial cells and fibroblasts. ACTA ACUST UNITED AC 2011; 3:189-97. [DOI: 10.1111/j.2041-1626.2011.00103.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Milanezi de Almeida J, Bosco AF, Bonfante S, Theodoro LH, Nagata MJH, Garcia VG. Nicotine-Induced Damage Affects Gingival Fibroblasts in the Gingival Tissue of Rats. J Periodontol 2011; 82:1206-11. [DOI: 10.1902/jop.2010.100549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Oshikohji T, Shimazaki Y, Shinagawa T, Fukui N, Akifusa S, Hirata Y, Yamashita Y. Relationship between receiving a workplace oral health examination including oral health instruction and oral health status in the Japanese adult population. J Occup Health 2011; 53:222-9. [PMID: 21471690 DOI: 10.1539/joh.o10031] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Dental caries and periodontal disease are highly prevalent in the Japanese adult population. Oral examination is an effective method to find various oral health problems in their early stages. However, workplace oral examination is not common in Japan. The purpose of this study was to examine the relationship between receiving workplace oral health examination, including oral health instruction, and oral health status in the Japanese adult population. METHODS This study was performed using data from 4,484 Japanese employees aged 35-74 yr. The proportion of teeth with a probing depth (PD) ≥4 mm and the number of decayed teeth were used for periodontal disease and dental caries parameters. The subjects were asked by questionnaire about past experiences with workplace oral health examination. RESULTS The subjects who received a workplace oral health examination every year had better periodontal health status than those receiving an examination for the first time. The odds ratio for having ≥10% of teeth with PD ≥4 mm in the subjects who received workplace oral health examination every year was 0.63 (p<0.05) after adjustment for age, sex, smoking habits, tooth-brushing habits, routine visits to dental clinics, number of missing teeth, and oral hygiene status, in a multivariate, multinomial logistic regression analysis. On the other hand, no significant relationship was found between workplace oral health examination and number of decayed teeth. CONCLUSIONS These results suggest that workplace oral health examination accompanied by oral health instruction may be effective for maintenance of periodontal health.
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Affiliation(s)
- Tadaaki Oshikohji
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science
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Radvar M, Darby I, Polster A, Arashi M, Moeintaghavi A, Sohrabi K. Pattern of cigarette smoking effect on periodontal pocketing and attachment loss: a retrospective study. Int J Dent Hyg 2011; 9:291-5. [PMID: 21356029 DOI: 10.1111/j.1601-5037.2010.00496.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM The aim of the present retrospective study was to evaluate the local effects of smoking on periodontium and to assess the patterns of periodontitis (pocket depths and attachment loss) in smokers and non-smokers. METHODS In this study, records of 126 non-smokers and 51 smokers (≥ 5 cigarettes/day) periodontitis patients were evaluated and probing pocket depth (PPD), clinical attachment level (CAL) and bleeding on probing (BOP) data were collected from clinical patients records. Patients' data were subject to two sample t-tests to assess the difference between the groups and to analysis of variance using the generalized linear model to seek associations between smoking and site positions, age and clinical parameters. RESULTS The difference between CAL of smokers and non-smokers was greatest at the anterior maxillary palatal sites (P = 0.002) and reached 1 mm. When the effect of different site positions as well as smoking as a between subject variable and age as a co-variate on the attachment level measurements were assessed using analysis of variance, significant effects for smoking, jaw (lower versus upper) and anterior-posterior position as well as age were detected. No significant interactions were found between smoking and any of the three position variables. CONCLUSION Lack of interaction between smoking and any of the three position variables indicates that the destructive effects of smoking on the periodontal tissues maybe mainly from systemic side-effects and almost independent of the site position within the mouth, although some additional local effects may be present in areas such as anterior palatal sites.
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Affiliation(s)
- M Radvar
- Department of Periodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Slot DE, Kranendonk AA, Van der Reijden WA, Van Winkelhoff AJ, Rosema NAM, Schulein WH, Van der Velden U, Van der Weijden FA. Adjunctive effect of a water-cooled Nd:YAG laser in the treatment of chronic periodontitis. J Clin Periodontol 2011; 38:470-8. [DOI: 10.1111/j.1600-051x.2010.01695.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Kubota M, Tanno-Nakanishi M, Yamada S, Okuda K, Ishihara K. Effect of smoking on subgingival microflora of patients with periodontitis in Japan. BMC Oral Health 2011; 11:1. [PMID: 21208407 PMCID: PMC3020163 DOI: 10.1186/1472-6831-11-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Accepted: 01/05/2011] [Indexed: 11/20/2022] Open
Abstract
Background Smoking is a risk factor for periodontitis. To clarify the contribution of smoking to periodontitis, it is essential to assess the relationship between smoking and the subgingival microflora. The aim of this study was to gain an insight into the influence of smoking on the microflora of Japanese patients with periodontitis. Methods Sixty-seven Japanese patients with chronic periodontitis (19 to 83 years old, 23 women and 44 men) were enrolled in the present study. They consisted of 30 smokers and 37 non-smokers. Periodontal parameters including probing pocket depth (PPD) and bleeding on probing (BOP) and oral hygiene status were recorded. Detection of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum/periodonticum, Treponema denticola and Campylobacter rectus in subgingival plaque samples was performed by polymerase chain reaction. Association between the detection of periodontopathic bacteria and smoking status was analyzed by multiple logistic regression analysis and chi-square test. Results A statistically significant association was found between having a PPD ≥ 4 mm and detection of T. denticola, P. intermedia, T. forsythia, or C. rectus, with odds ratios ranging from 2.17 to 3.54. A significant association was noted between BOP and the detection of C. rectus or P. intermedia, and smoking, with odds ratios ranging from 1.99 to 5.62. Prevalence of C. rectus was higher in smokers than non-smokers, whereas that of A. actinomycetemcomitans was lower in smokers. Conclusions Within limits, the analysis of the subgingival microbial flora in smokers and non-smokers with chronic periodontitis suggests a relevant association between smoking and colonization by the specific periodontal pathogens including C. rectus.
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Affiliation(s)
- Michiya Kubota
- Oral Health Science Center, Tokyo Dental College, Chiba, Japan
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Shimazaki Y, Akifusa S, Takeshita T, Shibata Y, Doi Y, Hata J, Ninomiya T, Hirakawa Y, Kiyohara Y, Yamashita Y. Effectiveness of the salivary occult blood test as a screening method for periodontal status. J Periodontol 2010; 82:581-7. [PMID: 21043793 DOI: 10.1902/jop.2010.100304] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Community-based periodontal examinations are not popular despite the high prevalence of periodontal disease among adults. This study examines the effectiveness of a novel salivary occult blood test (SOBT) as a screening method for periodontal status. METHODS Comprehensive health examinations were conducted in adult residents aged ≥40 years in Hisayama, Fukuoka, Japan; 1,998 subjects, each with ≥20 teeth, were analyzed. A paper test strip was used to perform the SOBT and was followed by a periodontal examination. Results were ranked as negative or positive. Subjects with ≥15% of teeth with bleeding on probing (BOP) or ≥1 tooth with a probing depth (PD) ≥4 mm were defined as having a poor periodontal status. The relationship between the results of the SOBT and periodontal parameters and among other variables was examined. RESULTS The sensitivity and specificity of the SOBT in screening for poor periodontal status were 0.72 and 0.52, respectively. In a multivariate logistic regression analysis, the results of the SOBT were significantly associated with the proportion of teeth with BOP and the proportion of teeth with PD ≥4 mm, independent of age, sex, use of antihypertensive medication, use of antidiabetic medication or insulin therapy, and the number of decayed or filled teeth. CONCLUSION The SOBT may offer a simple screening method for periodontal status when a thorough periodontal examination is not possible, although it is not sufficiently specific to be a reasonable substitute for a periodontal examination.
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Affiliation(s)
- Yoshihiro Shimazaki
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth, and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
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Abstract
INTRODUCTION Smoking is an independent risk factor for periodontal disease and tooth loss. STATE OF THE ART Smoking impairs inflammatory and immune responses to periodontal pathogens, and exerts both systemic and local effects. Periodontal disease is increased both in prevalence and severity in smokers. Smoking is a predisposing factor to acute necrotizing ulcerative gingivitis and is associated with an increased rate of periodontal disease in terms of pocket formation and attachment loss, as well as alveolar bone loss. Cigar, pipe, water-pipe and cannabis smoking have similar adverse effects on periodontal health as cigarette smoking. Passive smoking is also an independent periodontal disease risk factor. Smokeless tobacco is associated with localized periodontal disease. Smokers respond less favourably to both non-surgical and surgical treatments and have higher failure rates and complications following dental implantation. Smoking cessation may halt the disease progression and improve the outcome of periodontal treatment. CONCLUSION Smoking cessation counselling should be an integral part of periodontal therapy and prevention.
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Affiliation(s)
- M Underner
- Unité de Tabacologie, Service de Pneumologie, Pavillon René Beauchant, CHU la Milétrie, BP 577, 86021 Poitiers cedex.
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Fullmer SC, Preshaw PM, Heasman PA, Kumar PS. Smoking cessation alters subgingival microbial recolonization. J Dent Res 2009; 88:524-8. [PMID: 19587156 DOI: 10.1177/0022034509338676] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Smoking cessation improves the clinical manifestations of periodontitis; however, its effect on the subgingival biofilm, the primary etiological agent of periodontitis, is unclear. The purpose of this study was to investigate, longitudinally, if smoking cessation altered the composition of the subgingival microbial community, by means of a quantitative, cultivation-independent assay for bacterial profiling. Subgingival plaque was collected at baseline, and 3, 6, and 12 months post-treatment from smokers who received root planing and smoking cessation counseling. The plaque was analyzed by terminal restriction fragment length polymorphism (t-RFLP). Microbial profiles differed significantly between smokers and quitters at 6 and 12 months following smoking cessation. The microbial community in smokers was similar to baseline, while quitters demonstrated significantly divergent profiles. Changes in bacterial levels contributed to this shift. These findings reveal a critical role for smoking cessation in altering the subgingival biofilm and suggest a mechanism for improved periodontal health associated with smoking cessation.
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Affiliation(s)
- S C Fullmer
- Section of Periodontology, College of Dentistry, The Ohio State University, 4111 Postle Hall, 305 W. 12 Avenue, Columbus, OH 43210, USA
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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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kurtis B, Tüter G, Serdar M, Pinar S, Demirel I, Toyman U. GCF MMP-8 Levels in Smokers and Non-Smokers With Chronic Periodontitis Following Scaling and Root Planing Accompanied by Systemic Use of Flurbiprofen. J Periodontol 2007; 78:1954-61. [DOI: 10.1902/jop.2007.070149] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Affiliation(s)
- Georgia K Johnson
- Department of Periodontics, University of Texas Health Sciences Center at San Antonio, USA
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Al-Bayaty FH, Wahid NAA, Bulgiba AM. Tooth mortality in smokers and nonsmokers in a selected population in Sana'a, Yemen. J Periodontal Res 2007; 43:9-13. [DOI: 10.1111/j.1600-0765.2007.00988.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kurtiş B, Tüter G, Serdar M, Pinar S, Demirel I, Toyman U. Gingival crevicular fluid prostaglandin E(2) and thiobarbituric acid reactive substance levels in smokers and non-smokers with chronic periodontitis following phase I periodontal therapy and adjunctive use of flurbiprofen. J Periodontol 2007; 78:104-11. [PMID: 17199546 DOI: 10.1902/jop.2007.060217] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND It has been established that smoking is an important risk factor for the initiation and progression of chronic periodontitis (CP). This study investigates the effects of phase I periodontal therapy and adjunctive flurbiprofen administration on prostaglandin E(2) (PGE(2)) and thiobarbituric acid reactive substance (TBARS) levels in gingival crevicular fluid (GCF) samples from smoker and non-smoker patients with CP. METHODS Twenty-one non-smoker and 21 smoker patients with CP were divided into four groups according to treatment modalities. Group 1 (non-smokers with CP) and group 3 (smokers with CP) patients received daily 100-mg flurbiprofen tablets in a 2 x 1 regimen for 10 days together with scaling and root planing (SRP). Patients in group 2 (non-smokers with CP) and group 4 (smokers with CP) received placebo tablets in a 2 x 1 regimen for 10 days together with SRP. Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) measurements were recorded and GCF samples were collected at baseline and on day 10 of drug intake from each sampling area by a single examiner who was unaware of the treatment modality. Assays for GCF PGE(2) and TBARS were carried out by an enzyme-linked immunosorbent assay and fluorometric method, respectively. RESULTS All groups showed statistically significant reductions in PI and GI scores following the phase I periodontal treatment on day 10 (P <0.05), but no statistical differences were observed in PD and CAL scores after the therapy. In groups 1 and 2, the reduction of GCF PGE(2) and TBARS levels were not significant after the therapy compared to baseline levels. In group 3, GCF PGE(2) and TBARS levels exhibited a statistically significant decrease (P <0.05) after the therapy. Group 4 showed significant reductions (P <0.05) in GCF PGE(2) levels after the therapy. No statistically significant reductions were observed in group 4 with regard to GCF TBARS levels. When groups 1 and 3 were compared according to GCF TBARS levels after the therapy, a more statistically significant reduction was observed in group 3 (P = 0.001). CONCLUSION These results suggest that additional flurbiprofen administration may have more inhibitory effects on GCF levels of PGE(2) and TBARS in the groups of smokers compared to non-smokers with CP.
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Affiliation(s)
- Bülent Kurtiş
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
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Erdemir EO, Bergstrom J. Relationship between smoking and folic acid, vitamin B12 and some haematological variables in patients with chronic periodontal disease. J Clin Periodontol 2007; 33:878-84. [PMID: 17092240 DOI: 10.1111/j.1600-051x.2006.01003.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this study was to investigate the relationship between cigarette smoking and the serum levels of folic acid, vitamin B(12) and some haematological variables in patients with periodontal disease. PATIENTS AND METHODS The study base consisted of 88 volunteer patients with periodontal disease, including 45 current smokers in the age range 31-68 years and 43 non-smokers in the range 32-66 years. The clinical parameters included plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL). Folic acid, vitamin B(12) and haematological variables were determined from peripheral blood samples. RESULTS PI, PD and CAL means were significantly higher in smokers than non-smokers (p<0.05). The serum folic acid concentration of smokers was lower than that of non-smokers (p<0.05), whereas the white blood cell count was higher in smokers than in non-smokers (p<0.05). CONCLUSION The results of this study suggest that among patients with periodontal disease the serum folic acid concentration is lower in smokers compared with non-smokers.
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Affiliation(s)
- Ebru Olgun Erdemir
- Periodontology Department, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
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Erdemir EO, Erdemir A. The detection of salivary minerals in smokers and non-smokers with chronic periodontitis by the inductively coupled plasma-atomic emission spectrophotometry technique. J Periodontol 2006; 77:990-5. [PMID: 16734573 DOI: 10.1902/jop.2006.050202] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate the effect of smoking on the salivary minerals in subjects with chronic periodontitis by the inductively coupled plasma-atomic emission spectrophotometry (ICP-AES) technique. METHODS The study group included 24 subjects-12 smokers and 12 non-smokers-with chronic periodontitis. Clinical measurements and non-stimulated whole saliva were obtained, and the levels of five elements-sodium, potassium, calcium, magnesium, and phosphate-in each specimen were analyzed. RESULTS When the clinical parameters were compared between groups, only plaque index was significantly higher in smokers than non-smokers (P <0.05). The mean plaque index of smokers and non-smokers was 1.93 +/- 0.51 and 1.51 +/- 0.39, respectively. The results of this study showed that there were no significant differences between groups in the mineral content of saliva. In smokers, there were positive correlations between the levels of calcium, sodium, and magnesium and clinical attachment level. There was also a positive correlation between the level of phosphate and the percentage of bleeding on probing. In non-smokers, there was a negative correlation only between the mean level of sodium and plaque index (P <0.05). CONCLUSIONS The present study showed that no significant differences were found between the mineral content of saliva of smokers and non-smokers by the ICP-AES technique. It is a useful, fast, and sensitive technique compared to other techniques, and it can be advised for researchers while analyzing the mineral content of saliva.
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Affiliation(s)
- Ebru Olgun Erdemir
- Department of Periodontology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
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Van der Velden U, Abbas F, Armand S, Loos BG, Timmerman MF, Van der Weijden GA, Van Winkelhoff AJ, Winkel EG. Java project on periodontal diseases. The natural development of periodontitis: risk factors, risk predictors and risk determinants. J Clin Periodontol 2006; 33:540-8. [PMID: 16899096 DOI: 10.1111/j.1600-051x.2006.00953.x] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify risk factors, risk predictors and risk determinants for onset and progression of periodontitis. MATERIAL AND METHODS For this longitudinal, prospective study all subjects in the age range 15-25 years living in a village of approximately 2000 inhabitants at a tea estate on Western Java, Indonesia, were selected. Baseline examination was carried out in 1987 and follow-up examinations in 1994 and 2002. In 2002, 128 subjects could be retrieved from the original group of 255. Baseline examination included evaluation of plaque, bleeding on probing, calculus, pocket depth, attachment loss and presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, spirochetes and motile microorganisms. RESULTS The mean attachment loss increased from 0.33 mm in 1987 to 0.72 mm in 1994 and 1.97 mm in 2002. Analysis identified the amount of subgingival calculus and subgingival presence of A. actinomycetemcomitans as risk factors, and age as a risk determinant, for the onset of disease. Regarding disease progression, the number of sites with a probing depth > or = 5 mm and the number of sites with recession were identified as risk predictors and male gender as a risk determinant. CONCLUSION Screening of these parameters early in life could be helpful in the prevention of onset and progression of periodontal diseases.
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Affiliation(s)
- U Van der Velden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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Shimazaki Y, Saito T, Kiyohara Y, Kato I, Kubo M, Iida M, Yamashita Y. The Influence of Current and Former Smoking on Gingival Bleeding: The Hisayama Study. J Periodontol 2006; 77:1430-5. [PMID: 16881812 DOI: 10.1902/jop.2006.050422] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Previous studies have shown that smoking is a risk factor for periodontitis and that it has a suppressive effect on gingival bleeding. This study examined the relationship between smoking, including past smoking, and periodontal conditions, mainly gingival bleeding, in a community-based health investigation. METHODS Smoking status was examined in 958 subjects, along with the quantity of tobacco currently or previously smoked (never, former light, former heavy, current light, and current heavy). We analyzed the influence of smoking on probing depth (PD), clinical attachment loss (CAL), and gingival bleeding on probing (BOP). RESULTS In multivariate logistic regression analyses, current heavy smokers were at a significantly greater risk for having a higher proportion of teeth with PD > or =4 mm and a higher proportion of teeth with CAL > or =5 mm; however, they had a lower risk for having a high BOP than did those who had never smoked. Moreover, both former light and former heavy smokers had significantly lower risks for high BOP. When the analysis was limited to subjects with PD > or =4 mm, former heavy and current heavy smokers showed a significant suppression of high BOP compared to never smokers. CONCLUSION This study suggests that smoking is significantly associated with PD and CAL and that current and past smoking has a suppressive effect on BOP.
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Affiliation(s)
- Yoshihiro Shimazaki
- Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, Fukuoka, Japan
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Baharin B, Palmer RM, Coward P, Wilson RF. Investigation of periodontal destruction patterns in smokers and non-smokers. J Clin Periodontol 2006; 33:485-90. [PMID: 16820036 DOI: 10.1111/j.1600-051x.2006.00934.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous work has suggested that tobacco smoking has a local as well as a systemic effect on the severity of periodontal disease. OBJECTIVE To test the hypothesis that smokers have more disease in the upper anterior region. METHODS A retrospective stratified random sample of 49 non-smokers and 39 heavy smokers (>or=20 cigarettes/day) was obtained from a total of 3678 referred patients with adult periodontitis. Probing depth data were collected from clinical records and radiographic measurements were carried out on existing dental panoramic tomographs to assess the inter-proximal bone levels. RESULTS The proportion of sites with "bone loss" 4.5 mm or greater was higher in smokers, the greatest difference being observed in upper anterior sites (smokers: 73.3+/-25.5%, non-smokers: 48.3+/-31.2%, p<0.001). A difference was also observed when the number of palatal sites probing 4 mm or greater in the upper anterior region was expressed as a proportion of all such sites in the mouth (smokers: 12.3+/-6.8%, non-smokers: 9.8+/-8.8%; p=0.050). CONCLUSION The overall pattern of tissue destruction was consistent with a systemic effect of smoking. The suggestion of a marginal local effect of the smoking habit in maxillary anterior palatal sites requires further investigation.
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Affiliation(s)
- Badiah Baharin
- Department of Periodontology, King's College London, Dental Institute at Guy's, King's and St Thomas' Hospital, London, UK
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Bozkurt FY, Yetkin Ay Z, Sütçü R, Delibaş N, Demirel R. Gingival Crevicular Fluid Leptin Levels in Periodontitis Patients With Long-Term and Heavy Smoking. J Periodontol 2006; 77:634-40. [PMID: 16584344 DOI: 10.1902/jop.2006.050277] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate gingival crevicular fluid (GCF) leptin levels and the influence of long-term and heavy smoking on GCF leptin levels in patients with chronic periodontitis. METHODS In this study, 143 individuals were divided into three groups: non-smokers (NS), smokers (S), and control (C). Three subgroups of NS and S were grouped as follows: a) probing depth (PD) <or=3 mm; b) PD = 4 to 5 mm; and c) PD >5 mm. For each patient, PD, gingival index (GI), plaque index (PI), gingival bleeding time index (GBTI), and clinical attachment level (CAL) values were recorded. The GCF leptin levels obtained from sampling sites were determined by using enzyme-linked immunosorbent assay kits. RESULTS The GCF leptin levels were found significantly lower in the a and b subgroups in the S group than those in the NS group (P <0.05). The inflammatory markers GI and GBTI showed significant correlations with leptin in NS (P <0.05). CONCLUSIONS Our results suggest that higher leptin GCF levels in healthy sites in periodontitis patients may play a protective role in periodontal disease. Further studies are needed to determine the cellular origin of the leptin in the gingiva and the effect of plasma leptin levels on GCF leptin concentrations.
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Affiliation(s)
- F Yeşim Bozkurt
- Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey.
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Lung ZHS, Kelleher MGD, Porter RWJ, Gonzalez J, Lung RFH. Poor patient awareness of the relationship between smoking and periodontal diseases. Br Dent J 2005; 199:731-7; discussion 725. [PMID: 16341187 DOI: 10.1038/sj.bdj.4812971] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2005] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate patients' knowledge of the effects of smoking on periodontal health. DESIGN Patient answered questionnaires, which were anonymous. SETTING Patients who attended GKT Dental Institute, King's College, London for dental treatment. SUBJECTS One thousand patients attending Restorative Consultant Clinics and Primary Dental Care. RESULTS Seventy-eight per cent of patients were aware that smoking had a negative impact on health. However, 52% of these patients who were aware could not state what the negative effects were on oral health. Seven per cent of patients stated that smoking affected the gums but did not state how it affected the gums. Only 6% of respondents knew specifically of the link between smoking and periodontal disease. The only statistically significant factors associated with increased awareness were smoking status, ie being a non-smoker and being registered with a general dental practitioner. Non-smokers and those registered with GDPs were more likely to be aware of the association between smoking and periodontal diseases. CONCLUSIONS This study highlights patients' lack of awareness of the relationship between smoking and periodontal diseases, with only 6% of respondents knowing of the link between tobacco and periodontal diseases.
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Affiliation(s)
- Z H S Lung
- GKT Dental Institute, Denmark Hill, London, SE 9RW.
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Persson RE, Kiyak AH, Wyatt CCI, Macentee M, Persson GR. Smoking, a weak predictor of periodontitis in older adults. J Clin Periodontol 2005; 32:512-7. [PMID: 15842268 DOI: 10.1111/j.1600-051x.2005.00701.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The impact of smoking habits on periodontal conditions in older subjects is poorly studied. AIMS To assess if a history of smoking is associated with chronic periodontitis and medical history in older subjects. MATERIAL AND METHODS The medical and dental history was collected from 1084 subjects 60-75 years of age. Smoking history information was obtained from self-reports. Periodontal variables [clinical probing depth (PD)>/=5.0 mm, clinical attachment levels (CALs) >/=4.0 mm], and radiographic evidence of alveolar bone loss were assessed. RESULTS 60.5% had never smoked (NS), 32.0% were former smokers (FS) (mean smoke years: 26.1 years, SD+/-13.1), and 7.5% were current smokers (CS) (mean smoke years 38.0 years, (SD+/-12.1). The proportional distribution of CAL >/=4.0 mm differed significantly by smoking status (NS and CS groups) (mean difference: 12.1%, 95% confidence interval (CI): 1.5-22.6, p<0.02). The Mantel-Haenszel common odds ratio between smoking status (CS+FS) and periodontitis (>20% bone loss) was 1.3 (p<0.09, 95% CI: 0.9-2.0) and changed to 1.8 (p<0.02, 95% CI: 1.3-2.7) with 30 years of smoking as cutoff. A weak correlation between number of years of smoking and CAL>/=4.0 mm was demonstrated (r(2) values 0.05 and 0.07) for FS and CS, respectively. Binary logistic forward (Wald) regression analysis demonstrated that the evidence of carotid calcification, current smoking status, gender (male), and the number of remaining teeth were explanatory to alveolar bone loss. CONCLUSIONS A clinically significant impact on periodontal conditions may require 30 years of smoking or more. Tooth loss, radiographic evidence of carotid calcification, current smoking status, and male gender can predictably be associated with alveolar bone loss in older subjects.
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Erdemir EO, Duran I, Haliloglu S. Effects of smoking on clinical parameters and the gingival crevicular fluid levels of IL-6 and TNF-alpha in patients with chronic periodontitis. J Clin Periodontol 2004; 31:99-104. [PMID: 15016034 DOI: 10.1111/j.0303-6979.2004.00454.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Smoking is an important environmental risk factor for the initiation and progression of periodontal diseases. The aim of this study was to evaluate the effects of smoking on clinical parameters and the gingival crevicular fluid (GCF) contents of the pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels in patients with chronic periodontitis. MATERIAL AND METHODS The study base consisted of 41 patients including 22 volunteer current smokers with an age range of 32-59 (44.41+/-7.88) years and 19 volunteer non-smokers with an age range of 36-59 (46.94+/-6.07) years. The first month after non-surgical periodontal therapy was accepted as the baseline of the study. The clinical parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL) were recorded and GCF samples were collected for analysis of GCF contents of IL-6 and TNF-alpha levels. At the 3rd and 6th months, all of these procedures were repeated. RESULTS In smokers, only CAL was significantly higher at the 3rd month compared with non-smokers (p<0.05). GI and BOP were higher in non-smokers than smokers in both periods (p<0.05). PI showed increases from the initial to the 6th month in smokers (p<0.05). Although the differences between two groups with regard to IL-6 and TNF-alpha were not significant (p>0.05), the total amount of TNF-alpha in GCF decreased from the initial to the 6th month in smokers (p<0.05). There were no significant correlations between the mean total amount of IL-6 and TNF-alpha in GCF and clinical parameters in both evaluation periods in smokers (p>0.05). CONCLUSION The present study demonstrated that cigarette smoking increases the amount of dental plaque over time in smokers and does not influence GCF contents of IL-6 and TNF-alpha.
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Affiliation(s)
- Ebru Olgun Erdemir
- Department of Periodontology, School of Dentistry, Selcuk University, Konya, Turkey.
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