Effects of Smoking on Clinical and Microbiological Response in Individuals With Periodontitis

Trakya University48 enrolled

Overview

This study aimed to compare the distribution of subgingival periodontal pathogens following non-surgical periodontal therapy in smoking and non-smoking people with periodontitis. The main question it aims to answer is: \- Does smoking affect the results of non-surgical periodontal treatment on subgingival flora in participants with periodontal disease? Researchers performed non-surgical periodontal therapy on 48 participants with stage III/IV periodontitis and recorded clinical measurements. They obtained subgingival plaque samples from periodontal pockets at the onset and after four weeks of treatment, determining the level of periodontopathogens using a polymerase chain reaction-based method.

The present study aims to compare the changes in clinical parameters and subgingival periodontopathogen rates (P. gingivalis, A. actinomycetemcomitans, T. forsythia, F. nucleatum, P. intermedia, T. denticola, P. micra, C. rectus, E. nodatum, Capnocytophaga spp, and E. corrodens) following full-mouth scaling and root planing procedures in participants with and without smoking habits.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Periodontitis Smoking Habit Subgingival Plaque

Interventions

An ultrasonic device (Cavitron Plus, Dentsply®, Duisburg, Germany) and periodontal hand instruments (periodontal curettes; Chicago, IL) were used for non-surgical periodontal treatment. The treatment procedure also included detailed oral hygiene instructions and full-mouth scaling and root planing. Scaling and root planing (SRP) was applied to all four quadrants under local anesthesia in a single appointment. No medication or mouthwash was prescribed to the patients.

Eligibility

Sex: ALLMin age: 35 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Having 15 or more permanent teeth (except third molars and teeth with endodontic lesions), * Having been diagnosed with generalized Stage III or IV periodontitis that progresses with periodontal support tissue loss in more than 30% of the teeth, * Having at least five teeth with probing depth(PD) ≥6mm, clinical attachment level(CAL) ≥5mm, and radiographic bone loss that extends to at least the middle of the root, * Having at least one tooth that meets the same PD and CAL criteria per quadrant. Exclusion Criteria: * Pregnancy or lactation, * Any systemic disease with a potential influence on the immune response (diabetes mellitus, bone metabolic diseases, immunosuppressive therapy, radiation etc.), * Existence of decay, restoration, or prosthesis on the sampling site, * Use of the anti-inflammatory drug and antibiotic within the last 3 months.

Outcomes

Primary Outcomes

Change in levels of periodontopathogens in subgingival plaque after non-surgical periodontal therapy in smokers and non-smokers with stage 3/4 periodontitis

The baseline levels of periodontopathogens (P. gingivalis, A. actinomycetemcomitans, T. forsythia, F. nucleatum, P. intermedia, T. denticola, P. micra, C. rectus, E. nodatum, Capnocytophaga spp, and E. corrodens), post-treatment levels, and elimination levels with treatment were evaluated using multiplex polymerase chain reaction (PCR) analysis.The observed rates of microorganisms were assessed by determining six main levels. 0: No colouring (\<1% no bacteria) 1. Very light-colored staining (Determination of bacteria from 1% to 20%). 2. Light colored staining (Determination of bacteria from 21% to 40%), 3. Moderate colored staining (Determination of bacteria from 41% to 60%), 4. Dark colored staining (Determination of bacteria from 61% to 80%), 5. Very dark-colored staining (Determination of bacteria from 81% to 100%).

Time frame: Baseline and four weeks after the periodontal therapy.

Secondary Outcomes

Change in clinical attachment level (CAL)

CAL is the main clinical parameter indicating the severity of periodontal disease. CAL measurements were performed on six different surfaces of each tooth (disto-buccal/labial, mid-buccal/labial, mesio-buccal/labial, disto-lingual, mid-lingual, and mesio lingual) by using a periodontal probe (Williams probe; Chicago, IL) and average value was calculated in millimeters. CAL 1-2 mm: Stage 1 periodontitis CAL 3-4 mm: Stage 2 periodontitis CAL ≥ 5 mm: Stage 3/4 periodontitis