A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters

Embora o tabagismo seja o maior fator de risco na prevalência, extensão e severidade das doenças periodontais, existem poucos estudos intervencionais sobre os benefícios do abandono do fumo sobre as condições periodontais. O objetivo deste estudo prospectivo de 12 meses foi avaliar o efeito do abandono do tabagismo no tratamento periodontal não-cirúrgico de pacientes com periodontite crônica severa. Materiais e Métodos: Dos 201 pacientes triados, 93 foram considerados elegíveis e receberam tratamento periodontal não-cirúrgico e tratamento para cessação do tabagismo simultâneamente. Foram realizados controle e manutenção periodontal a cada três meses, após o término do tratamento periodontal. Um único examinador calibrado e cego para a condição de fumante realizou exame periodontal completo em seis sítios por dente, no início, 3, 6 e 12 meses após o tratamento não-cirúrgico periodontal. Outro examinador aferiu a concentração de monóxido de carbono expirado e realizou entrevista com base em um questionário estruturado, a fim de coletar dados demográficos e de hábitos tabágicos, nos mesmos períodos. Resultados: Dos 93 indivíduos incluídos, 52 permaneceram no estudo até 12 meses de acompanhamento. Destes, 17 pararam de fumar e 35 continuaram fumando ou oscilaram. Após um ano, somente os que pararam de fumar apresentaram ganho clinico de inserção significante (p = 0,04). No entanto, não houve diferenças entre os grupos de pacientes que pararam de fumar e não pararam de fumar ou que oscilaram em relação ao nível de inserção clínica, profundidade de sondagem, sangramento à sondagem e índice de placa após um ano (p > 0,05). Conclusão: Indivíduos que pararam de fumar apresentaram ganho clinico de inserção significante após um ano de acompanhamento.Although smoking is the major risk factor in the prevalence, extent and severity of periodontal diseases, there are few data from intervention studies regarding the benefits of quitting smoking on periodontal conditions. The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in nonsurgical periodontal therapy of subjects with severe chronic periodontitis. Materials and Methods: Of the 201 enrolled subjects, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every three months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. Results: Of the 93 eligible subjects, 52 remained in the study after one year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After one year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between subjects who quit smoking or who did not regarding clinical attachment level, probing depth, bleeding on probing and plaque index after one year (p>0.05). Conclusion: Quitters presented significant clinical attachment gain after one year of follow-up

A prospective 24-month study of the effect of smoking cessation on non-surgical periodontal therapy

Embora o tabagismo seja um importante fator de risco para as doenças periodontais, ainda não existem estudos a longo prazo que demonstrem o benefício do abandono do fumo sobre as condições periodontais. O objetivo deste estudo prospectivo de 24 meses foi avaliar o efeito do abandono do tabagismo no tratamento periodontal não cirúrgico de pacientes com periodontite crônica severa. Materiais e Métodos: Dos 286 pacientes triados, 116 foram considerados elegíveis e receberam tratamento periodontal não cirúrgico e tratamento para cessação do tabagismo simultaneamente. Foram realizados controle e manutenção periodontal a cada três meses, após o término do tratamento periodontal. Um único examinador calibrado e cego para a condição de fumante realizou exame periodontal completo em seis sítios por dente, no início, 3, 12 e 24 meses após o tratamento periodontal não cirúrgico. Outro examinador aferiu a concentração de monóxido de carbono expirado e realizou entrevista por meio de um questionário estruturado, a fim de coletar dados demográficos e hábitos tabágicos, nos mesmos períodos. Resultados: Dos 116 sujeitos incluídos, 61 permaneceram no estudo por 24 meses de acompanhamento. Destes, 18 pararam de fumar (NF), 32 continuaram fumando (F) e 11 oscilaram (O). Ao longo de 24 meses todos os grupos apresentaram redução significativa no número de cigarros fumados. Os grupos NF e F apresentaram redução significativa no índice de placa e o grupo NF redução significativa no sangramento à sondagem. Quando comparado com F, aos 24 meses, NF apresentou redução significativa na concentração de monóxido de carbono exalado, na porcentagem de sítios com nível clinico de inserção maior igual a 3mm, na profundidade de sondagem de todos os sítios e daqueles inicialmente doentes e ganho de inserção significativo para sítios inicialmente doentes (p> 0,05). Conclusão: Parar de fumar promoveu benefício adicional ao tratamento periodontal não cirúrgico de pacientes com periodontite crônica severa, após 24meses de acompanhamento.Although smoking is an important risk factor for periodontal diseases, there are no long term studies that demonstrate the benefit of smoking cessation on periodontal conditions. The aim of this 24-month prospective study was to assess the effect of smoking cessation on non-surgical periodontal therapy of subjects with severe chronic periodontitis. Materials and Methods: Of the 286 screened subjects, 116 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every three months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 12 and 24 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. Results: Of the 116 subjects enrolled, 61 remained in the study up to 24 months of follow-up. Of these, 18 quit smoking (Q), 32 continued smoking (NQ) and 11 oscillated (O). Over the 24 months, all groups showed significant reduction in the number of consumed cigarettes. Q and NQ groups showed significant reduction in plaque index and Q presented significant reduction in bleeding index. When compared with NQ at 24 months, Q showed a significant reduction in the concentration of exhaled carbon monoxide, in the percentage of sites with CAL 3 mm, in probing depth for all sites and for initially diseased sites and greater attachment gain for initially diseased sites (p> 0.05). Conclusion: Smoking cessation promotes adjunctive benefits in non-surgical periodontal therapy of subjects with severe chronic periodontitis

Smoking and periodontal tissues: a review

The impact of smoking on general health has been widely studied and is directly related to several important medical problems including cancer, low birth weight, and pulmonary and cardiovascular disease. In the past 25 years, there has also been an increasing awareness of the role of cigarette consumption in oral health problems such as periodontal disease. Smoking is considered the major risk factor in the prevalence, extent and severity of periodontal diseases. This article will discuss the available evidence and provide the reader with an overview of the impact of smoking and its cessation on the pathogenesis and treatment of periodontal diseases

A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters

P>Aim The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in non-surgical periodontal therapy of subjects with severe chronic periodontitis. Materials and methods Of the 201 subjects enrolled from a smoking cessation clinic, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every 3 months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. Results Of the 93 eligible subjects, 52 remained in the study after 1 year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After 1 year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between the groups regarding clinical attachment level, probing depth, bleeding on probing and plaque index after 1 year (p > 0.05). Conclusion Smoking cessation promoted clinical attachment gain in chronic periodontitis subjects from a smoking cessation clinic after 1 year of follow-up.Sao Paulo Research Foundation (FAPESP)[07/54494-3

Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study

Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16–12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76–19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76–30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55–20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables