The Influence of Smoking in Periodontitis Patients, Before and After Nonsurgical Treatment

University of Medicine and Pharmacy at Ho Chi Minh City

Status

Completed

Conditions

Periodontitis

Treatments

Procedure: Nonsurgical periodontal treatment

Study type

Interventional

Funder types

Other

Identifiers

NCT04974502

92/DHYD-HDDD

Details and patient eligibility

About

Objective: The aim of this study was to evaluate and compare the oral neutrophil numbers (ONN) in saliva, the level of matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid (GCF) and the periodontal parameters in smokers and non-smokers with periodontitis, before and after nonsurgical periodontal treatment (NSPT).

Materials and method: 40 periodontitis patients including 20 smokers and 20 non-smokers were enrolled in this study. All patients were received the NSPT included instructing oral hygiene, scaling and root planning. Clinical parameters (plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss (CAL)), ONN and GCF MMP-8 level were assessed before (baseline) and after NSPT 1 month and 3 months.

Full description

After periodontal examination and medical history evaluation, all patients received oral hygiene instructions. The modified-Bass tooth brushing technique, as well as the use of dental floss and interproximal brushes (if needed) were showed to the patients. They were educated to brush their teeth at least twice a day. All patients were given a dentifrice and toothbrush. Patient motivation to quit smoking was also provided.

At the first visit, supragingival scaling with ultrasonic scalers (Cavitron Jet Plus (Densply Sirona, Mississauga, Canada) were provided to all patients. Occlusion adjustments were also performed in the case of indications.

After one week, the baseline (T0) parameters were recorded. The following samples were collected: (1) saliva, (2) gingival cervical fluid (GCF), and (3) clinical periodontal parameters. A doctor who collected the samples was blinded about the smoking status.

Subsequently, scaling and root planning (SRP) by ultrasonic scalers (Cavitron Jet Plus (Densply Sirona, Mississauga, Canada) and Gracey curettes (Hu-Friedy, Chicago, USA), under local anesthesia, were performed by a periodontist, who was also blinded about the smoking status. The number of SRP visits was determined by patient disease conditions.

Following the completion of NSPT, all subjects were recalled after one month and three months for re-evaluation. The collection of (1) saliva, (2) gingival cervical fluid (GCF), and (3) clinical periodontal parameters were performed. Based on the patients' periodontal status, supragingival scaling and polishing were given.

Enrollment

40 patients

Sex

Male

Ages

30 to 60 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Male patients
Aged from 30 to 60 years old
Systemically healthy
Having at least 20 teeth
Diagnosed with moderate to severe periodontitis according to american academy of periodontology 2015: gingival bleeding at examination, ≥5mm periodontal pocket depth (PPD), bone resorption on x-ray film ≥16% or >3mm root length
Having at least two sites at anterior teeth with PPD from 5 to 7 mm
For group 1, subjects who never smoke
For group 2, subjects who had smoked more than 10 cigarettes per day for at least the past 10 years

Exclusion criteria

Patients with acute or chronic medical disorders
Patients under any medication for the past 3 months
Patients who had undergone periodontal therapy in the last 12 months
Patients with oral lesions such as ulcers, aphthous ulcers, glossitis or multi tooth decays