Platelet Rich Plasma and Bone Graft in Smokers and Non-smokers

Objective: The purpose of this study was to assess the effect of smoking on regenerative periodontal treatment in advanced chronic periodontitis patients. Methods: A total of 24 advanced chronic periodontitis patients, 12 smokers (S) and 12 non-smokers (NS) who received non-surgical periodontal therapy and had radiographical interproximal defects with an associated probing depth (PD) of > 6 mm and an intrabony component of > 3 mm, were included. A total of 115 defects (56 defects in S, 59 defects in NS) met the criteria for inclusion. In every patient, platelet rich plasma (PRP) and bovine derived xenograft (BDX) (PRP+BDX) combination were used. Prior to surgery and at 12 months, plaque and sulcus bleeding indices, probing depth (PD), marginal soft tissue, relative attachment, probing and radiographic bone levels were measured. Results: At 12 months, the mean PD reduction in S was 3.68±0.88 mm (p<0.01), whereas in NS this reduction was 5.30±1.18 mm (p<0.01). The change in relative attachment level in S was 2.50±1.42 mm (p<0.01), whereas in NS this change was 5.19±1.83 mm. Evaluation of the hard tissue findings revealed that the mean clinical and radiographic bone gains in S and NS were 2.24±1.67 mm (p<0.01) and 4.67±1.76 mm (p<0.01), and 2.97±0.39 mm (p<0.01) and 4.08±1.36 mm (p<0.01), respectively. An intergroup comparison revealed significant differences for PD, recession, attachment gain, clinical and radiographic bone gains, yielding a more favourable outcome towards NS group. Conclusion: Within the limits of this study, smoking affects the clinical healing in intrabony defects treated with PRP+BDX in advanced chronic periodontitis patients. The mechanisms of this effect should be investigated further.