Hughes Francis J, Syed Mahnaz, Koshy Bindhu, Bostanci Nagihan, McKay Ian J, Curtis Michael A, Marcenes Wagner, Croucher Raymond E
Collaborative Group in Risk Factors for Periodontal Disease, Centre for Adult Oral Health, Institute of Dentistry, London, UK.
J Clin Periodontol. 2006 Sep;33(9):671-6. doi: 10.1111/j.1600-051X.2006.00965.x. Epub 2006 Jul 20.
The aim of this study was to investigate the effects of smoking on the response to non-surgical treatment for aggressive periodontitis.
Seventy-nine patients with generalized aggressive periodontitis were included in the study; 20 were smokers. All patients received a course of non-surgical periodontal therapy and outcomes assessed 10 weeks post-operatively. Non-responding patients were designated if they had 30% or more non-responding deep sites.
At baseline, bleeding scores were lower in smokers. There was no difference in baseline plaque, pocket depth (PD), recession or clinical attachment levels (CALs); when sites were selected by equal levels of CAL, increased recession was seen in smokers. Outcomes were poorer in smokers (mean PD change 1.75+/-0.56 versus 2.23+/-0.87 mm). The odds ratio for 30% of sites not responding in smokers was 2.9; for 40% non-responding it was 5.9. Smoking altered the distribution of site-specific responses to increase specifically the number of non-responding sites. There was no significant difference in responses between ex-smokers and never-smokers.
The results demonstrate that smoking is a major risk factor for poor response to initial treatment and emphasize the importance of smoking cessation in periodontal therapy.
本研究旨在调查吸烟对侵袭性牙周炎非手术治疗反应的影响。
79例广泛性侵袭性牙周炎患者纳入本研究；其中20例为吸烟者。所有患者均接受了一个疗程的非手术牙周治疗，并在术后10周评估治疗结果。如果患者有30%或更多的深部位点无反应，则被认定为无反应患者。
在基线时，吸烟者的出血评分较低。基线时菌斑、牙周袋深度（PD）、牙龈退缩或临床附着水平（CAL）无差异；当根据相同水平的CAL选择位点时，吸烟者的牙龈退缩增加。吸烟者的治疗结果较差（平均PD变化1.75±0.56对2.23±0.87mm）。吸烟者30%的位点无反应的优势比为2.9；40%无反应时为5.9。吸烟改变了位点特异性反应的分布，特别增加了无反应位点的数量。戒烟者和从不吸烟者之间的反应无显著差异。
结果表明，吸烟是初始治疗反应不佳的主要危险因素，并强调了在牙周治疗中戒烟的重要性。
