Ardais Rodrigo, Mário Ticiane de Góes, Boligon Jociana, Kantorski Karla Zanini, Moreira Carlos Heitor Cunha
Department of Stomatology, Dental School, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
Braz Oral Res. 2014;28:1-7. doi: 10.1590/1807-3107bor-2014.vol28.0058. Epub 2014 Oct 21.
The objective of this study was to evaluate the effect of smoking on response to nonsurgical periodontal therapy using the primary outcome measure of bleeding on probing (BoP). An periodontist performed periodontal therapy on 11 smokers and 14 never smokers with periodontitis. Two examiners assessed visible plaque index, gingival bleeding index, probing pocket depth (PPD), BoP, suppuration on probing and clinical attachment level (CAL), at baseline and three months after therapy. BoP was categorized as 0 (absent), 1 (small bleeding point) and 2 (blood flow from the sulcus). Total BoP value was obtained by summing values of 1 and 2. All subjects had significant reductions in mean PPD and percentages of sites with BoP, with no difference between the groups. Only never smokers presented statistically significant CAL gain. BoP was significantly and consistently reduced at sites with initial PPDs of 1-3 mm and 4-6 mm in both groups. At sites with deep PPD ( ≥ 7mm), never smokers showed a greater mean reduction in the number of sites with BoP than did smokers (p < 0.05). Never smokers had significantly greater reduction in BoP 2 than smokers, at sites with moderate and deep baseline PPDs. The first group had a significant increase of BoP 1, at sites with initial PPDs of 4-6 mm. Thus, periodontal therapy reduced BoP in both groups. However, smoking could negatively affect the BoP reduction at deeper sites after nonsurgical periodontal therapy.
本研究的目的是使用探诊出血（BoP）这一主要结局指标，评估吸烟对非手术牙周治疗反应的影响。一名牙周病医生对11名吸烟者和14名从未吸烟的牙周炎患者进行了牙周治疗。两名检查者在基线和治疗后三个月评估了可见菌斑指数、牙龈出血指数、探诊袋深度（PPD）、BoP、探诊时的化脓情况以及临床附着水平（CAL）。BoP分为0（无）、1（小出血点）和2（从龈沟流血）。总BoP值通过将1和2的值相加获得。所有受试者的平均PPD和有BoP的部位百分比均显著降低，两组之间无差异。只有从未吸烟的患者出现了具有统计学意义的CAL增加。两组中，初始PPD为1 - 3mm和4 - 6mm的部位，BoP均显著且持续降低。在PPD较深（≥7mm）的部位，从未吸烟的患者在有BoP的部位数量上的平均降低幅度大于吸烟者（p < 0.05）。在基线PPD为中度和深度的部位，从未吸烟的患者在BoP 2方面的降低幅度显著大于吸烟者。第一组在初始PPD为4 - 6mm的部位，BoP 1有显著增加。因此，牙周治疗使两组的BoP均降低。然而，吸烟可能会对非手术牙周治疗后较深部位的BoP降低产生负面影响。
