Kanmaz Burcu, Lappin David F, Nile Christopher J, Buduneli Nurcan
Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
Oral Sciences Research Group, School of Medicine, Dentistry and Nursing, Glasgow Dental School, University of Glasgow, Glasgow, UK.
J Periodontol. 2020 Apr;91(4):442-453. doi: 10.1002/JPER.19-0141. Epub 2019 Sep 14.
To evaluate possible effects of smoking on clinical, biochemical, and microbiological outcomes of non-surgical periodontal treatment in patients with periodontitis Stage III or IV and Grade C.
Conventional quadrant-wise non-surgical periodontal treatment was performed and whole-mouth periodontal measurements were recorded at baseline, 1, 3, and 6 months after completion of treatment. Saliva, gingival crevicular fluid, subgingival plaque, and blood samples were obtained at the same time points. Inflammatory cytokine levels, presence, and quantities of 11 different bacterial species were determined. Smoking status was validated by cotinine assay.
Fourteen smoker and 13 non-smoker patients completed the study protocol and revealed similar clinical findings except for the higher plaque scores in the non-smokers at 6 months (P <0.01). Significant differences were found between the study groups in biofluid cytokine levels at 1 and 3 months (P <0.01). Gram-negative bacteria were more abundant in the smokers at baseline and so were Gram-positive bacteria in the non-smokers (P <0.01). Gram-negative bacteria repopulated in the smokers faster than in the non-smokers (P <0.01).
The present findings suggest that smoker patients with periodontitis Stage III and IV, Grade C respond well to the non-surgical periodontal treatment during the 6-month follow-up. However, smokers exhibit faster repopulation of Gram-negative bacteria.
评估吸烟对III或IV期C级牙周炎患者非手术牙周治疗的临床、生化和微生物学结果的可能影响。
进行常规的象限式非手术牙周治疗，并在治疗开始时、治疗完成后1个月、3个月和6个月记录全口牙周测量数据。在相同时间点采集唾液、龈沟液、龈下菌斑和血液样本。测定炎症细胞因子水平、11种不同细菌种类的存在情况和数量。通过可替宁检测验证吸烟状态。
14名吸烟患者和13名非吸烟患者完成了研究方案，除6个月时非吸烟者的菌斑评分较高外（P<0.01），两组临床结果相似。研究组在1个月和3个月时生物流体细胞因子水平存在显著差异（P<0.01）。基线时吸烟者中革兰氏阴性菌较多，非吸烟者中革兰氏阳性菌较多（P<0.01）。吸烟者中革兰氏阴性菌的再定植速度比非吸烟者快（P<0.01）。
目前的研究结果表明，III和IV期C级牙周炎吸烟患者在6个月随访期间对非手术牙周治疗反应良好。然而，吸烟者中革兰氏阴性菌的再定植速度更快。
