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Impaired healing response of periodontal furcation defects following flap debridement surgery in smokers
Author(s) -
Trombelli Leonardo,
Cho KyooSung,
Kim ChongKwan,
Scapoli Chiara,
Scabbia Alessandro
Publication year - 2003
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1034/j.1600-051x.2003.10182.x
Subject(s) - medicine , furcation defect , dentistry , periodontitis , bleeding on probing , debridement (dental) , significant difference , molar
Objectives: The purpose of the present parallel‐design, controlled clinical trial was to evaluate the treatment outcome of periodontal furcation defects following flap debridement surgery (FDS) procedure in cigarette smokers compared to non‐smokers. Materials and Methods: After initial therapy, 31 systemically healthy subjects with moderate to advanced periodontitis, who presented at least one Class I or II molar furcation defect, were selected. Nineteen patients (mean age: 40.3 years, 15 males) were smokers (≥10 cigarettes/day) and 12 patients (mean age: 44.8 years, 3 males) were non‐smokers. Full‐mouth plaque score (FMPS) and full‐mouth bleeding score (FMBS), probing pocket depth (PPD), vertical clinical attachment level (v‐CAL), and horizontal clinical attachment level (h‐CAL) were assessed immediately before and 6 months following surgery. Results: Overall, statistically significant v‐CAL gain was observed in smokers (1.0 ± 1.3 mm) and non‐smokers (1.3±1.1 mm), the difference between groups being statistically significant ( p =0.0003). In proximal furcation defects, v‐CAL gain amounted to 2.3±0.7 mm in non‐smokers as compared to 1.0±1.1 mm in smokers ( p =0.0013). At 6 months postsurgery, non‐smokers presented a greater h‐CAL gain (1.3±1.1 mm) than smokers (0.6±1.0 mm), with a statistically significant difference between groups ( p =0.0089). This trend was confirmed in both facial/lingual (1.4±1.0 versus 0.8±0.8 mm) and proximal furcation defects (1.2±1.3 versus 0.5±1.2 mm). The proportion of Class II furcations showing improvement to postsurgery Class I was 27.6% in smokers and 38.5% in non‐smokers. After 6 months, 3.4% of presurgery Class I furcation defects in smokers showed complete closure, as compared to 27.8% in non‐smokers. Conclusions: The results of the present study indicated that (1) FDS produced clinically and statistically significant PPD reduction, v‐CAL gain, and h‐CAL gain in Class I/II molar furcation defects, and (2) cigarette smokers exhibited a less favorable healing outcome following surgery in terms of both v‐CAL and h‐CAL gain.