Salhi Leila, Albert Adelin, Seidel Laurence, Lambert France
Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, 4000 Liège, Belgium.
Department of Public Health Sciences, University of Liège, 4000 Liège, Belgium.
J Clin Med. 2020 Aug 3;9(8):2491. doi: 10.3390/jcm9082491.
Oral hygiene instructions (OHI) and periodontal nonsurgical treatment (PNST) play pivotal roles in the management of periodontitis. The study aims to discern their respective effects on periodontal clinical parameters and patient-reported outcome measures (PROMs).
Ninety-one patients were included, 34 non-smokers (NS), 25 former smokers (FS) and 32 current smoker (CS). Clinical parameters such as probing depth (PD) and bleeding on probing (BOP) were collected, and the periodontal inflamed tissue area (PISA) was calculated. Clinical parameters and PROMs were recorded before and after receiving OHI, with electronic tooth brush and interdental brushes, as well as 3 months after debridement.
Smokers presented a significantly higher proportion of severe periodontitis (64.7%) with generalized extension (76.5%) and with a rapid rate of progression (97.1%) compared to NS and FS. OHI led to a significant decrease of PD, BOP, and PISA < 0.0001) only in NS and FS. Debridement reduced PD and the percentage of PD >6 mm in all groups ( < 0.0001). OHI induced significant improvement of oral hygiene, frequency of interdental cleaning, and PROMs ( < 0.0001). Further debridement induced significant additional improvement PROMs in FS and NS < 0.0001).
OHI and debridement improved periodontal clinical parameters and PROMs in both NS and FS. Former smokers had comparable outcomes to non-smokers, suggesting that smoking cessation should be encouraged.
口腔卫生指导（OHI）和牙周非手术治疗（PNST）在牙周炎的管理中起着关键作用。本研究旨在辨别它们对牙周临床参数和患者报告结局指标（PROMs）的各自影响。
纳入91名患者，其中34名非吸烟者（NS）、25名既往吸烟者（FS）和32名当前吸烟者（CS）。收集诸如探诊深度（PD）和探诊出血（BOP）等临床参数，并计算牙周炎症组织面积（PISA）。在接受使用电动牙刷和牙间隙刷的OHI之前和之后，以及在清创后3个月记录临床参数和PROMs。
与NS和FS相比，吸烟者中重度牙周炎的比例显著更高（64.7%），具有广泛分布（76.5%）且进展速度快（97.1%）。OHI仅在NS和FS中导致PD、BOP和PISA显著降低（<0.0001）。清创在所有组中均降低了PD以及PD>6mm的百分比（<0.0001）。OHI使口腔卫生、牙间隙清洁频率和PROMs得到显著改善（<0.0001）。进一步的清创在FS和NS中使PROMs得到显著的额外改善（<0.0001）。
OHI和清创改善了NS和FS的牙周临床参数和PROMs。既往吸烟者的结局与非吸烟者相当，表明应鼓励戒烟。
