THE EFFECT OF SMOKING ON THE RESPONSE TO PERIODONTAL THERAPY

This study evaluated the effect of smoking on the clinical response to non-surgical and surgical periodontal therapy. 74 adult subjects with moderate to advanced periodontitis were treated according to a split- mouth design involving the following treatment modalities: coronal sca ling, root planing, modified Widman surgery, and flap with osseous res ectional surgery. Clinical parameters assessed included probing depth, probing attachment level, horizontal attachment level in furcation si tes, recession, presence of supragingival plaque and bleeding on probi ng. Data were collected: initially, 4 weeks following phase-I therapy, 10 weeks following phase-II therapy and on a yearly basis during 6 ye ars of maintenance care. Data analysis demonstrated that smokers exhib ited significantly less reduction of probing depth and less gain of pr obing attachment level when compared to non-smokers immediately follow ing active therapy and during each of the 6 years of maintenance (p<0. 05). A greater loss of horizontal attachment level was evident in smok ers at each yearly exam during maintenance therapy (p<0.05). There wer e no differences between groups in recession changes. In general, thes e findings were true for the outcomes following all 4 modalities of th erapy and were most pronounced in the deepest probing depth category ( greater than or equal to 7 mm). Statistical analysis showed a tendency for smokers to have slightly more supragingival plaque and bleeding o n probing. In summary, smokers responded less favorably than non-smoke rs to periodontal therapy which included 3-month maintenance follow-up .