Department of Periodontology, Center for Oral Rehabilitation, Falun, Sweden.
Public Dental Service, Falun, Sweden.
J Clin Periodontol. 2020 Mar;47(3):343-350. doi: 10.1111/jcpe.13228. Epub 2019 Dec 26.
To investigate the impact of smoking on the reduction of pockets >4 mm deep and a composite variable of residual pockets >4 mm and bleeding on probing (BoP) after treatment.
Eligible after exclusion due to missing records were 3,535 individuals, referred for periodontal treatment between 1980 and 2015. The number of teeth (NT), probing pocket depth (PPD), proportion of plaque (PLI) and BoP were registered before treatment and 1 year after treatment. To analyse the impact of smoking on PPD reduction, a mixed model adjusted for age, sex, type of therapy, baseline PPD, reduction of PLI, BoP and NT was used. Depending on residual PPD and BoP, two categories were created: good and poor responders.
PLI was reduced by 20% in non-smokers and by 18% in smokers, and BoP by 46% and 37%, respectively. In the adjusted mixed model, the mean reduction of PPD > 4 mm among smokers undergoing surgery was 14.4 versus 9.7 in non-smokers (p < .001). The odds ratio for being a poor responder was 2.40 (95% CI 1.99-2.91, p < .001) for smokers.
Although surgical treatment reduced PPD >4 mm in smokers more effectively than in non-smokers, significantly more non-smokers were good responders after periodontal therapy.
研究吸烟对治疗后牙周袋深度>4mm 减少和牙周袋残留>4mm 和探诊出血（BoP）复合变量的影响。
排除因记录缺失而不合格的患者后，共纳入 3535 名于 1980 年至 2015 年期间接受牙周治疗的患者。在治疗前和治疗 1 年后记录牙齿数量（NT）、探诊袋深度（PPD）、菌斑比例（PLI）和 BoP。为了分析吸烟对 PPD 减少的影响，采用调整年龄、性别、治疗类型、基线 PPD、PLI 减少、BoP 和 NT 的混合模型进行分析。根据残留 PPD 和 BoP，创建了两个类别：良好和不良应答者。
非吸烟者的 PLI 降低了 20%，吸烟者降低了 18%，BoP 分别降低了 46%和 37%。在调整后的混合模型中，手术治疗的吸烟者 PPD>4mm 的平均减少量为 14.4，而非吸烟者为 9.7（p<0.001）。吸烟者不良应答的比值比为 2.40（95%CI 1.99-2.91，p<0.001）。
尽管手术治疗对吸烟者的 PPD>4mm 减少效果优于非吸烟者，但牙周治疗后，非吸烟者中更多的是良好应答者。
