Scabbia A, Cho K S, Sigurdsson T J, Kim C K, Trombelli L
Research Center for the Study of Periodontal Diseases, University of Ferrara, Italy.
J Periodontol. 2001 Jan;72(1):43-9. doi: 10.1902/jop.2001.72.1.43.
The purpose of the present parallel design, controlled clinical trial was to evaluate the treatment outcome following flap debridement surgery (FDS) in cigarette smokers compared to non-smokers.
After initial therapy, 57 systemically healthy subjects with moderate to advanced periodontitis who presented with one area (at least 3 teeth) where surgery was required were selected. Twenty-eight patients (mean age: 39.6 years, 20 males) were smokers (> or = 10 cigarettes/day); 29 patients (mean age: 43.9 years, 7 males) were non-smokers. Full-mouth plaque (FMP) and bleeding on probing (BOP) scores, probing depth (PD), clinical attachment level (CAL), and recession depth (RD) were assessed immediately before and 6 months following surgery. Only sites with presurgery PD > or = 4 mm were used for statistical analysis.
Presurgery FMP and BOP were similar in smokers and non-smokers and significantly decreased postsurgery in both groups. Overall, PD reduction and CAL gain were greater, although not significantly, in non-smokers (2.4 +/- 0.9 mm and 1.6 +/- 0.7 mm, respectively) than in smokers (1.9 +/- 0.7 mm and 1.2 +/- 0.7 mm, respectively). For moderate sites (PD 4 to 6 mm), no significant differences in PD and CAL changes were found between groups. For deep sites (PD > or = 7 mm), PD reduction was 3.0 +/- 1.0 mm in smokers and 4.0 +/- 0.8 mm in non-smokers, and CAL gain amounted to 1.8 +/- 1.1 mm in smokers and 2.8 +/- 1.0 mm in non-smokers (P = 0.0477). In smokers, 16% of deep sites healed to postsurgery PD values < or = 3 mm as compared to 47% in non-smokers (P = 0.0000); 58% of deep sites in smokers showed a CAL gain > or = 2 mm, as compared to 82% in non-smokers (P = 0.0000).
Results of the study indicated that: 1) FDS determined a statistically significant PD reduction and CAL gain in patients with moderate to advanced periodontitis; 2) smokers exhibited a trend towards less favorable healing response following FDS compared to non-smokers, both in terms of PD reduction and CAL gain; and 3) this trend reached clinical and statistical significance at sites with initial deep PD.
本平行设计的对照临床试验旨在评估与非吸烟者相比，吸烟者行瓣清创术（FDS）后的治疗效果。
初始治疗后，选择57例患有中度至重度牙周炎且全身健康的受试者，这些受试者有一个需要手术的区域（至少3颗牙）。28例患者（平均年龄：39.6岁，20例男性）为吸烟者（每天吸烟≥10支）；29例患者（平均年龄：43.9岁，7例男性）为非吸烟者。在手术前及术后6个月时评估全口菌斑（FMP）、探诊出血（BOP）评分、探诊深度（PD）、临床附着水平（CAL）和退缩深度（RD）。仅将术前PD≥4mm的部位用于统计分析。
吸烟者和非吸烟者术前FMP和BOP相似，两组术后均显著降低。总体而言，非吸烟者（分别为2.4±0.9mm和1.6±0.7mm）的PD减少和CAL增加幅度虽不显著，但大于吸烟者（分别为1.9±0.7mm和1.2±0.7mm）。对于中度部位（PD为4至6mm），两组间PD和CAL变化无显著差异。对于深度部位（PD≥7mm），吸烟者的PD减少为3.0±1.0mm，非吸烟者为4.0±0.8mm，吸烟者的CAL增加为1.8±1.1mm，非吸烟者为2.8±1.0mm（P = 0.0477）。吸烟者中，16%的深度部位术后愈合至PD值≤3mm，而非吸烟者为47%（P = 0.0000）；吸烟者中58%的深度部位CAL增加≥2mm，而非吸烟者为82%（P = 0.0000）。
研究结果表明：1）FDS在中度至重度牙周炎患者中可使PD显著降低且CAL增加；2）吸烟者在FDS后的愈合反应在PD减少和CAL增加方面均比非吸烟者更不理想；3）在初始PD较深的部位，这种趋势具有临床和统计学意义。
