Impact of smoking on the clinical, microbiological and immunological parameters of adult patients with periodontitis
- 3 August 2005
- journal article
- research article
- Published by Wiley in Journal of Clinical Periodontology
- Vol. 32 (9), 973-983
- https://doi.org/10.1111/j.1600-051x.2005.00788.x
Abstract
The aim of the current study was to assess the impact of smoking on the clinical indices, the humoral immune response and the detection frequency of putative periodontal pathogens in patients with periodontitis cross-sectionally and following therapy. Clinical measurements, subgingival plaque samples, gingival crevicular fluid (GCF) and sera were collected from 40 untreated patients with moderate-to-advanced chronic periodontitis before and after treatment over a period of 6 months. The treatment consisted of the initial therapy of scaling and root planing. Smoking status was self-reported and was confirmed by cotinine enzyme inhibition assay (CEIA). Whole-mouth clinical measurements were recorded with a manual periodontal probe at baseline (BAS) and at 6 months (RAS). Selected-site analyses were performed on the deepest site in each quadrant before and after therapy and clinical indices were recorded with an electronic pressure-sensitive probe. GCF sample volume was quantified using the Periotron 6000. Polymerase chain reaction (PCR) was utilized to determine the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Treponema denticola and Tanerella forsythensis in subgingival plaque. Enzyme-linked immunosorbent assay examined the systemic antibody titres to these bacteria, and thiocyanate disassociation determined the antibody avidity to these organisms. At baseline, smokers showed significantly less gingival inflammation and lower GCF volume compared with non-smokers. After treatment, a compromised clinical outcome was noted for smokers in terms of pocket depth reduction and gain in attachment levels. No significant differences in the detection of putative periodontal pathogens in subgingival plaque existed between smokers and non-smokers. A consistent trend was noted in that smokers had lower sera immunoglobulin G antibody titres to these organisms before and after treatment (statistically significant for A. actinomycetemcomitans). This pattern was less clear when antibody avidities were considered, revealing only small differences, if any, between the two groups of patients. Current data indicate that smokers with periodontal disease have a suppressed inflammatory response, a significantly less favourable clinical outcome and seem to have an altered host antibody response to antigenic challenge than non-smokers. In contrast, the subgingival microflora of smokers appears similar to that of non-smokers.Keywords
This publication has 61 references indexed in Scilit:
- Detection of Prevotella intermedia in subgingival plaque of adult periodontitis patients by polymerase chain reactionJournal of Periodontal Research, 2010
- Quadrant root planing versus same‐day full‐mouth root planingJournal of Clinical Periodontology, 2004
- Oral microbiota in smokers and non‐smokers in natural and experimentally‐induced gingivitisJournal of Clinical Periodontology, 1998
- Tobacco and Smoking: Environmental Factors That Modify the Host Response (Immune System) and Have an Impact On Periodontal HealthCritical Reviews in Oral Biology & Medicine, 1997
- Periodontal healing and periopathogenic microflora in smokers and non‐smokersJournal of Clinical Periodontology, 1995
- Occurrence of periopathogens in smoker and non‐smoker patientsJournal of Clinical Periodontology, 1992
- Humoral Immune Responses to Porphyromonas gingivalis Before and Following Therapy in Rapidly Progressive Periodontitis PatientsThe Journal of Periodontology, 1991
- The Effect of Nicotine on the Attachment of Human Fibroblasts to Glass and Human Root Surfaces in VitroThe Journal of Periodontology, 1988
- Noxious effect of cigarette smoking on periodontal healthJournal of Periodontal Research, 1987
- Periodontal Disease in Pregnancy II. Correlation Between Oral Hygiene and Periodontal ConditionActa Odontologica Scandinavica, 1964