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Cigarette smoking negatively affects healing response following flap debridement surgery

 Alessandro Scabbia  ;  Kyoo-Sung Cho  ;  Thorarinn J. Sigurdsson  ;  Chong-Kwan Kim  ;  Leonardo Trombelli 
 JOURNAL OF PERIODONTOLOGY, Vol.72(1) : 43-49, 2001 
Journal Title
Issue Date
Adult ; Aged ; Chi-Square Distribution ; Confidence Intervals ; Debridement* ; Dental Plaque Index ; Female ; Follow-Up Studies ; Gingival Hemorrhage/surgery ; Gingival Recession/surgery ; Humans ; Male ; Middle Aged ; Periodontal Attachment Loss/surgery ; Periodontal Index ; Periodontal Pocket/surgery ; Periodontitis/surgery* ; Single-Blind Method ; Smoking/adverse effects* ; Statistics as Topic ; Surgical Flaps* ; Treatment Outcome ; Wound Healing
Periodontal diseases/surgery ; smoking/adverse effects ; clinicaltrials, controlled ; surgical flaps ; follow-up studies
BACKGROUND: The purpose of the present parallel design, controlled clinical trial was to evaluate the treatment outcome following flap debridement surgery (FDS) in cigarette smokers compared to non-smokers. METHODS: After initial therapy, 57 systemically healthy subjects with moderate to advanced periodontitis who presented with one area (at least 3 teeth) where surgery was required were selected. Twenty-eight patients (mean age: 39.6 years, 20 males) were smokers (> or = 10 cigarettes/day); 29 patients (mean age: 43.9 years, 7 males) were non-smokers. Full-mouth plaque (FMP) and bleeding on probing (BOP) scores, probing depth (PD), clinical attachment level (CAL), and recession depth (RD) were assessed immediately before and 6 months following surgery. Only sites with presurgery PD > or = 4 mm were used for statistical analysis. RESULTS: Presurgery FMP and BOP were similar in smokers and non-smokers and significantly decreased postsurgery in both groups. Overall, PD reduction and CAL gain were greater, although not significantly, in non-smokers (2.4 +/- 0.9 mm and 1.6 +/- 0.7 mm, respectively) than in smokers (1.9 +/- 0.7 mm and 1.2 +/- 0.7 mm, respectively). For moderate sites (PD 4 to 6 mm), no significant differences in PD and CAL changes were found between groups. For deep sites (PD > or = 7 mm), PD reduction was 3.0 +/- 1.0 mm in smokers and 4.0 +/- 0.8 mm in non-smokers, and CAL gain amounted to 1.8 +/- 1.1 mm in smokers and 2.8 +/- 1.0 mm in non-smokers (P = 0.0477). In smokers, 16% of deep sites healed to postsurgery PD values < or = 3 mm as compared to 47% in non-smokers (P = 0.0000); 58% of deep sites in smokers showed a CAL gain > or = 2 mm, as compared to 82% in non-smokers (P = 0.0000). CONCLUSIONS: Results of the study indicated that: 1) FDS determined a statistically significant PD reduction and CAL gain in patients with moderate to advanced periodontitis; 2) smokers exhibited a trend towards less favorable healing response following FDS compared to non-smokers, both in terms of PD reduction and CAL gain; and 3) this trend reached clinical and statistical significance at sites with initial deep PD.
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2. College of Dentistry (치과대학) > Dept. of Periodontics (치주과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chong Kwan(김종관)
Cho, Kyoo Sung(조규성) ORCID logo https://orcid.org/0000-0002-6777-5287
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