Department of Dental Clinics, Oral Pathology, and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
J Periodontol. 2019 Aug;90(8):856-865. doi: 10.1002/JPER.18-0635. Epub 2019 Mar 12.
This study followed individuals in periodontal maintenance therapy (PMT) over 6 years and longitudinally evaluated the effects of cumulative smoking exposure and duration of smoking cessation on the recurrence of periodontitis.
From a 6-year follow-up cohort study with 212 individuals in PMT, 142 patients who attended at least one PMT visit within 12 months were determined to be elegible. According to smoking habits they were categorized into three groups: non-smokers (NS; n = 95), former smokers (FS; n = 22), and current smokers (CS; n = 25). Complete periodontal examination and smoking habits were evaluated at two instances: T1 (first time, after active periodontal therapy) and T2 (second time, 6 years). Associations between the recurrence of periodontitis (RP; probing depth ≥4 mm and clinical attachment loss ≥3 mm, together with the presence of bleeding on probing and/or suppuration), smoking status, and potential risk variables were analyzed by univariate and multivariate analysis, when appropriate.
The RP in NS, FS, and CS groups was 44.2%, 68.2%, and 80.0%, respectively. After adjusting for confounders, odds ratios (95% confidence interval) for the RP in T2 was 2.80 (2.11 to 5.14) for FS and 5.97 (3.58 to 9.88) for CS. There was a significant dose-response relationship between pack-years of smoking and the RP, as well as a significant decrease in the risk for the RP as the years of smoking cessation increased.
During 6 years of PMT, cumulative smoking exposure and shorter time since smoking cessation were significantly associated with the RP.
本研究对牙周维护治疗（PMT）中的个体进行了 6 年的随访，并纵向评估了累积吸烟暴露量和戒烟持续时间对牙周炎复发的影响。
从一项为期 6 年的随访队列研究中，选择了 212 名接受 PMT 的个体，其中有 142 名患者在 12 个月内至少接受了一次 PMT 就诊，被认为符合条件。根据吸烟习惯，他们被分为三组：非吸烟者（NS；n=95）、曾经吸烟者（FS；n=22）和当前吸烟者（CS；n=25）。在两个时间点（T1：牙周治疗后首次；T2：6 年后）评估完整的牙周检查和吸烟习惯。在适当的情况下，通过单变量和多变量分析，分析牙周炎复发（RP；探诊深度≥4mm 和临床附着丧失≥3mm，同时伴有探诊出血和/或溢脓）与吸烟状况和潜在风险变量之间的关联。
NS、FS 和 CS 组的 RP 分别为 44.2%、68.2%和 80.0%。调整混杂因素后，T2 时 FS 和 CS 组 RP 的比值比（95%置信区间）分别为 2.80（2.11 至 5.14）和 5.97（3.58 至 9.88）。吸烟包年数与 RP 之间存在显著的剂量-反应关系，随着戒烟年限的增加，RP 的风险显著降低。
在 6 年的 PMT 期间，累积吸烟暴露量和戒烟时间较短与 RP 显著相关。
