Effects of Smoking on Outcome of Treatment of Aggressive Periodontitis

Effects Of Smoking On Outcome Of Treatment Of Aggressive Periodontitis M Syed, B Koshy, MA Curtis, W Marcenes, RE Croucher, FJ Hughes. Objective:As part of our ongoing studies of prognostic factors in the treatment of Aggressive Periodontitis, the aim of the study presented here was to investigate the effects of smoking on the outcome of nonsurgical treatment of patients with aggressive periodontitis. Methods:Patients with aggressive periodontitis were recruited and received a standardised 4-visit course of nonsurgical periodontal therapy as previously reported (Hughes et BSDR 2005). Self reported smoking history was taken by questionnaire and supplemented by measurement of expired CO2 by smokelyser. Outcome to treatment was assessed 10 weeks post operatively. Results:A total of 83 patients completed treatment of which 23 patients were current smokers. There was a good correlation between self reported smoking and smokelyser measurements R2=0.65, P<0.0001). Non-smokers had significantly higher bleeding scores pre treatment (80% + 26% vs. 54 ± 34%; P<0.05) but no differences in plaque scores. The mean pocket depth reduction was significantly lower in smokers (1.33 ± 1.11mm vs. 1.86± 0.5mm; P < 0.05). Smokers had more recession at baseline and a higher increase in recession following treatment. The percentage of non-responding sites was significantly higher in the smoking group as compared to the non smoking group 30.3% vs. 17.7% P<0.05%. Further analysis revealed that in smokers the odds ratio of having 20% of sites that did not respond was 3.2 (1.055 to 9.59 -95% CI) ; the odds ratio of 40% of sites not responding to treatment in the smoking group was 8.0 (2.059 to 31.08-95% CI). Conclusions:These results confirm that smoking has a major negative impact on the outcome of periodontal treatment and extend previous work by providing a quantitative assessment of the magnitude of this effect.