Tonetti M S, Pini-Prato G, Cortellini P
Department of Periodontology and Fixed Prostodontics, University of Bern, Switzerland.
J Clin Periodontol. 1995 Mar;22(3):229-34. doi: 10.1111/j.1600-051x.1995.tb00139.x.
This retrospective study examined the effect of cigarette smoking on the healing response following guided tissue regeneration (GTR) in deep infrabony defects. 71 defects in 51 patients underwent GTR with teflon membranes. 20 patients (32 defects) smoked more than 10 cigarettes per day, while 31 patients (39 defects) did not smoke. Clinical measurements were available at baseline, at membrane removal and at the 1-year follow-up. The oral hygiene of both groups was good, but smokers had significantly higher full-mouth plaque scores. No significant differences were observed between smokers and non-smokers in terms of % of tissue gained at membrane removal. At the 1-year follow-up, however, smokers gained significantly less probing attachment level than non-smokers (2.1 +/- 1.2 mm compared with 5.2 +/- 1.9 mm). A multivariate model, correcting for the oral hygiene level of the patients and the depth of the infrabony component, indicated that smoking was in itself a significant factor in determining the clinical outcome. A risk-assessment analysis indicated that smokers had a significantly greater risk than non-smokers to display a reduced probing attachment level gain following GTR. It is concluded that cigarette smoking is associated with a reduced healing response after GTR treatment, and may be responsible, at least in part, for the observed results.
这项回顾性研究探讨了吸烟对深骨下袋缺损引导组织再生（GTR）后愈合反应的影响。51例患者的71处缺损接受了使用聚四氟乙烯膜的GTR治疗。20例患者（32处缺损）每天吸烟超过10支，而31例患者（39处缺损）不吸烟。在基线、膜去除时和1年随访时均有临床测量数据。两组的口腔卫生状况良好，但吸烟者的全口菌斑评分显著更高。在膜去除时，吸烟者和非吸烟者在组织获得百分比方面未观察到显著差异。然而，在1年随访时，吸烟者获得的探诊附着水平显著低于非吸烟者（分别为2.1±1.2mm和5.2±1.9mm）。一个校正了患者口腔卫生水平和骨下袋成分深度的多变量模型表明，吸烟本身是决定临床结果的一个重要因素。风险评估分析表明，吸烟者在GTR后探诊附着水平增加减少的风险显著高于非吸烟者。结论是，吸烟与GTR治疗后愈合反应降低有关，并且可能至少部分地导致了观察到的结果。
