Clinical Effects of Smoking on Initial Periodontal Treatment in Patients with Stage III Grade C Periodontitis

Öz

Objective: This study aimed to determine the impact of smoking on clinical parameters and GCF volume following initial periodontal therapy (IPT). Material and Methods: A total of 42 participants, 14 non-smoker periodontally healthy and 28 stage III grade C periodontitis (14 non-smokers and 14 smokers) individuals, were included. All clinical periodontal parameters, plaque index (PI), gingival index (GI), bleeding on probing (BoP), pocket depth (PD) and clinical attachment level (CAL), were recorded and gingival crevicular fluid (GCF) samples were collected from all patients at baseline from all participants, and 1 and 3 months after IPT from periodontitis patients. Results: At baseline, all clinical parameters and GCF volume were lower in the healthy group than in the periodontitis groups (p<0.001). 1 and 3 months after IPT, the reductions were seen in all clinical parameters and GCF volüme in non-smoker and smoker stage III grade C periodontitis groups (p<0.001). At 3 months after IPT, GI, PD, and CAL were lower, and GCF volume was higher in the non-smoker stage III grade C periodontitis group compared to the smoking stage III stage C periodontitis group. (p<0.05). Conclusions: Although improvement was observed with IPT in both non-smoker and smoker periodontitis patients, smoking was found to have a negative effect on IPT.

Anahtar Kelimeler

• periodontal pocket
• periodontitis
• smoking

Sigaranın Evre III Derece C Periodontitisli Hastalarda Başlangıç Periodontal Tedavi Üzerindeki Klinik Etkileri

Öz

Amaç: Bu çalışmanın amacı, sigaranın başlangıç periodontal tedavi (BPT) sonrası klinik parametreler ve dişeti oluğu sıvısı (DOS) hacmi üzerindeki etkisini değerlendirmektir. Gereç ve Yöntemler: Çalışmaya 14 sigara içmeyen periodontal sağlıklı ve 28 evre III derece C periodontitisli (14 sigara içmeyen ve 14 sigara içen) birey olmak üzere toplam 60 katılımcı dahil edildi. Başlangıçta, tüm bireylerin plak indeks (Pİ), gingival indeks (Gİ), sondalamada kanama (SK), cep derinliği (CD) ve klinik ataşman seviyesini (KAS) içeren klinik periodontal parametreler kaydedildi ve tüm bireylerden DOS örnekleri toplandı. BPT sonrası 1. ve 3. Ayda periodontitisli bireylerde klinik ölçümler ve DOS örneği alımı tekrarlandı. Bulgular: Başlangıçta tüm klinik parametreler ve DOS hacmi sağlıklı grupta periodontitis gruplarına göre daha düşük görüldü (p<0.001). BPT sonrası 1. ve 3. ayda sigara içmeyen ve sigara içen evre III derece C periodontitis gruplarında tüm klinik parametrelerde ve DOS hacminde azalma meydana geldi (p<0.001). BPT sonrası 3. ayda, sigara içmeyen evre III derece C periodontitis grubunda, sigara içen evre III evre C periodontitis grubuna göre Gİ, CD ve KAS daha düşük, DOS hacmi ise daha yüksek tespit edildi (p<0.05). Sonuç: Sigara içen ve içmeyen periodontitisli hastalarda BPT ile iyileşme görülmesine rağmen, sigaranın BPT üzerinde negatif etkisi olduğu tespit edildi.

Anahtar Kelimeler

• periodontal cep
• periodontitis
• sigara

Kaynakça

1. Berezow AB, Darveau RP. Microbial shift and periodontitis. Periodontol 2000. 2011;55(1):36. doi: 10.1111/j.1600-0757.2010.00350.x
2. Page RC, Kornman KS. The pathogenesis of human periodontitis: an introduction. Periodontol 2000. 1997;14(1):9-11. doi:10.1111/j.1600-0757.1997. tb00189.x
3. Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol 2000. 2013;62(1):59-94. doi:10.1111/j.1600-0757.2012.00457.x
4. Yasuda H. Discovery of the RANKL/RANK/ OPG system. J Bone Miner Metab. 2021;39(1):2-11. doi:10.1007/s00774-020-01175-1
5. Faddy MJ, Cullinan MP, Palmer JE, Westerman B, Seymour GJ. Ante-dependence modeling in a longitudinal study of periodontal disease: the effect of age, gender, and smoking status. J Periodontol. 2000;71(3):454-9. doi:10.1902/jop.2000.71.3.454
6. Jansson L, Lavstedt S. Influence of smoking on marginal bone loss and tooth loss–a prospective study over 20 years. J Clin Periodontol. 2002;29(8):750-6. doi:10.1034/j.1600-051X.2002.290812.x
7. Johnson GK, Guthmiller JM. The impact of cigarette smoking on periodontal disease and treatment. Periodontol 2000. 2007;44(1):178-94.
8. Dietrich T, Bernimoulin JP, Glynn RJ. The effect of cigareté smoking on gingival bleeding. J Periodontol. 2004;75(1):16-22. doi:10.1902/jop.2004.75.1.16

9. Arıkan V, Görgülü NG, Doğan B. Clinical and Biochemical Effects of Smoking on Non-Surgical Periodontal Treatment in Grade III Stage C Periodontitis Patients. Clin Exp Health Sci. 2023;13(1):218-27. doi:10.33808/clinexphealthsci.1128101
10. Baumert Ah MK, Johnson GK, Kaldahl WB, Patil KD, Kalkwart KL. The effect of smoking on the response to periodontal therapy. J Clin Periodontol. 1994;21(2):91-7. doi:10.1111/j.1600-051X.1994. tb00285.x
11. Knight ET, Liu J, Seymour GJ, Faggion Jr CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000. 2016;71(1):22-51. doi:10.1111/ prd.12110
12. Renvert S, Dahlén G, Wikström M. The clinical and microbiological effects of non-surgical periodontal therapy in smokers and non-smokers. J Clin Periodontol. 1998;25(2):153-7. doi:10.1111/j.1600-051X.1998. tb02421.x
13. Ardais R, Mario 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. doi:10.1590/1807-3107BOR-2014.vol28.0058
14. Preshaw P, Holliday R, Law H, Heasman P. Outcomes of non-surgical periodontal treatment by dental hygienists in training: impact of site-and patient-level factors. Int J Dent Hyg. 2013;11(4):273-9. doi: 10.1111/ idh.12032
15. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018;89:S159-S72. doi:10.1002/JPER.18-0006
16. Lang NP, Bartold PM. Periodontal health. J Clin Periodontol. 2018;45 Suppl 20:S9-S16.
17. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand. 1964;22:121- 35.
18. Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533-51.
19. Cekici A, Kantarci A, Hasturk H, Van Dyke TE. Inflammatory and immune pathways in the pathogenesis of periodontal disease. Periodontol 2000. 2014;64(1):57- 80. doi: 10.1111/prd.12002
20. Kuru L, Parkar M, Griffiths G, Newman H, Olsen I. Flow cytometry analysis of gingival and periodontal ligament cells. J Dent Res. 1998;77(4):555- 64. doi:0.1177/002203459807700408
21. Hendek MK, Erdemir EO, Kisa U, Ozcan G. Effect of initial periodontal therapy on oxidative stress markers in gingival crevicular fluid, saliva, and serum in smokers and non-smokers with chronic periodontitis. J Periodontol. 2015;86(2):273-82. doi:10.1902/ jop.2014.140338
22. Johnson GK, Hill M. Cigarette smoking and the periodontal patient. J Periodontol. 2004;75(2):196-209. doi: 10.1902/jop.2004.75.2.196
23. Kinane D, Chestnutt I. Smoking and periodontal disease. Crit Rev Oral Biol Med. 2000;11(3):356-65. doi: 38 10.1177/104544110001100305
24. Laxman VK, Annaji S. Tobacco use and its effects on the periodontium and periodontal therapy. J Contemp Dent Pract. 2008;9(7):97-107.
25. Ebersole JL, Kirakodu S, Novak MJ, Stromberg AJ, Shen S, Orraca L, et al. Cytokine gene expression profiles during initiation, progression and resolution of periodontitis. J Clin Periodontol. 2014;41(9):853-61. doi: 10.1111/jcpe.12286
26. Haffajee A, Socransky S. Relationship of cigarette smoking to the subgingival microbiota. J Clin Periodontol. 2001;28(5):377-88. doi:10.1034/j.1600- 051x.2001.028005377.x
27. Heasman L, Stacey F, Preshaw P, McCracken G, Hepburn S, Heasman P. The effect of smoking on periodontal treatment response: a review of clinical evidence. J Clin Periodontol. 2006;33(4):241-53. doi:10.1111/j.1600-051X.2006.00902.x
28. Caton JG, Armitage G, Berglundh T, Chapple IL, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions–Introduction and key changes from the 1999 classification. Wiley Online Library; 2018. p. S1-S8. doi:10.1002/JPER.18-0157
29. Emingil G, Çinarcik S, Baylas H, Çoker I, Hüseyinov A. Levels of leukotriene B4 in gingival crevicular fluid and gingival tissue in specific periodontal diseases. J Clin Periodontol. 2001;72(8):1025-31. doi:10.1902/jop.2001.72.8.1025
30. Gomes SC, Piccinin FB, Oppermann RV, Susin C, Marcantonio RAC. The effect of smoking on gingival crevicular fluid volume during the treatment of gingivitis. Acta Odontol Latinoam. 2009;22(3):201-6.
31. Mokeem S, Vellappally S, Preethanath R, Hashem M, Al-Kheraif A, Anil S. Influence of smoking on clinical parameters and gingival crevicular fluid volume in patients with chronic periodontitis. Oral health and Dent Manag. 2014;13(2):469-73.
32. Greenstein G. Periodontal response to mechanical non-surgical therapy: a review. J Periodontol. 1992;63(2):118-30. doi:10.1902/jop.1992.63.2.118
33. Badersten A, Nilvéus R, Egelberg J. Effect of nonsurgical periodontal therapy. J Clin Periodontol. 1981;8(1):57-72. doi: 10.1111/j.1600-051X.1981. tb02024.x
34. Morrison EC, Ramfjord SP, Hill R. Short-term effects of initial, nonsurgical periodontal treatment (hygienic phase). J Clin Periodontol. 1980;7(3):199-211. doi:10.1111/j.1600-051X.1980.tb01963.x
35. Segelnick SL, Weinberg MA. Reevaluation of initial therapy: when is the appropriate time? J Periodontol. 2006;77(9):1598-601. doi:10.1902/jop.2006.050358
36. Afacan B, Keleş Yücel ZP, Paşali Ç, Atmaca Ilhan H, Köse T, Emingil G. Effect of non-surgical periodontal treatment on gingival crevicular fluid hypoxia inducible factor-1 alpha, vascular endothelial growth factor and tumor necrosis factor-alpha levels in generalized aggressive periodontitis patients. J Periodontol. 2020;91(11):1495-502. doi:10.1002/ JPER.19-0521
37. Görgülü NG, Doğan B. Effect of non-surgical periodontal treatment on salivary and serum biomarkers in Stage III Grade B and C periodontitis. J Periodontol. 2022.
38. Keles Yucel ZP, Balli U. Leucine-rich alpha-2 glycoprotein (LRG): A novel acute phase protein expressed in stage 3 grade C periodontitis before and after periodontal therapy. J Periodontol. 2021;92(1):104- 12. doi:10.1002/JPER.20-0358
39. Yashima A, Morozumi T, Yoshie H, Hokari T, Izumi Y, Akizuki T, et al. Biological responses following one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial. J Periodontal Res. 2019;54(6):709-19. doi:10.1111/ jre.12680
40. Bunæs DF, Lie SA, Enersen M, Aastrøm AN, Mustafa K, Leknes KN. Site-specific treatment outcome in smokers following non-surgical and surgical periodontal therapy. Clin Periodontol. 2015;42(10):933- 42. doi:10.1111/jcpe.12462
41. Faveri M, Rebello A, de Oliveira Dias R, Borges-Junior I, Duarte PM, Figueiredo LC, et al. Clinical and microbiologic effects of adjunctive metronidazole plus amoxicillin in the treatment of generalized chronic periodontitis: smokers versus non-smokers. J Periodontol. 2014;85(4):581-91. doi:10.1902/jop.2013.130278
42. Dosumu E, Lawal F, Akinyemi O. Smokers and non-smokers: A comparison of oral health practices and effect of non surgical periodontal therapy on their periodontium. Niger Postgrad Med J. 2015;22(2):110-6.
43. da Silva RVC, Rangel TP, Corrêa MG, de Freitas Monteiro M, Casati MZ, Ruiz KG, et al. Smoking negatively impacts the clinical, microbiological, and immunological treatment response of young adults with Grade C periodontitis. J Periodontal Res. 2022;57(6):1116-26.
44. Jin L, Wong K, Leung W, Corbet E. Comparison of treatment response patterns following scaling and root planing in smokers and non-smokers with untreated adult periodontitis. J Clin Dent. 2000;11(2):35-41.
45. Labriola A, Needleman I, Moles DR. Systematic review of the effect of smoking on nonsurgical periodontal therapy. Periodontol 2000. 2005;37(1):124- 37. doi:0.1111/j.1600-0757.2004.03793.x
46. Meseli SE, Bahar K, Leyla K. Relationships between initial probing depth and changes in the clinical parameters following non-surgical periodontal treatment in chronic periodontitis. JIUFD. 2017;51(3):11-7.
47. Caldeira FID, Hidalgo MAR, Dias MLDC, Scarel-Caminaga RM, Pigossi SC. Systematic review of ratios between disease/health periodontitis modulators and meta-analysis of their levels in gingival tissue and biological fluids. Arch Oral Biol. 2021;127:105147. doi:10.1016/j.archoralbio.2021.105147
48. Çelen S, Öngöz Dede F, Avşar C. Role of Inhibitor SMADs in Stage 3 Grade B periodontitis before and after periodontal treatment. J Periodontal Res. 2022;57(1):41-51. doi:10.1111/jre.12935
49. Haffajee A, Cugini M, Dibart S, Smith C, Kent Jr R, Socransky S. The effect of SRP on the clinical and microbiological parameters of periodontal diseases. J Clin Periodontol. 1997;24(5):324-34. doi:10.1111/ j.1600-051X.1997.tb00765.x
50. Üstün K, Alptekin NÖ. The effect of tobacco smoking on gingival crevicular fluid volume. Eur J Dent. 2007;1(04):236-9. Doi: 10.1055/s-0039-1698345
51. Apatzidou D, Riggio M, Kinane D. Impact of smoking on the clinical, microbiological and immunological parameters of adult patients with periodontitis. J Clin Periodontol. 2005;32(9):973-83. doi:10.1111/j.1600-051X.2005.00788.x