The Influence of Smoking in Periodontitis Patients, Before and After Nonsurgical Treatment
Condition: Periodontitis
MeSH terms: Periodontitis
Study type: Interventional

Summary: 
      Objective: The aim of this study was to evaluate and compare the oral neutrophil numbers
      (ONN) in saliva, the level of matrix metalloproteinase-8 (MMP-8) in gingival crevicular fluid
      (GCF) and the periodontal parameters in smokers and non-smokers with periodontitis, before
      and after nonsurgical periodontal treatment (NSPT).

      Materials and method: 40 periodontitis patients including 20 smokers and 20 non-smokers were
      enrolled in this study. All patients were received the NSPT included instructing oral
      hygiene, scaling and root planning. Clinical parameters (plaque index (PlI), gingival index
      (GI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss
      (CAL)), ONN and GCF MMP-8 level were assessed before (baseline) and after NSPT 1 month and 3
      months.
    

Detailed description: 
      After periodontal examination and medical history evaluation, all patients received oral
      hygiene instructions. The modified-Bass tooth brushing technique, as well as the use of
      dental floss and interproximal brushes (if needed) were showed to the patients. They were
      educated to brush their teeth at least twice a day. All patients were given a dentifrice and
      toothbrush. Patient motivation to quit smoking was also provided.

      At the first visit, supragingival scaling with ultrasonic scalers (Cavitron Jet Plus (Densply
      Sirona, Mississauga, Canada) were provided to all patients. Occlusion adjustments were also
      performed in the case of indications.

      After one week, the baseline (T0) parameters were recorded. The following samples were
      collected: (1) saliva, (2) gingival cervical fluid (GCF), and (3) clinical periodontal
      parameters. A doctor who collected the samples was blinded about the smoking status.

      Subsequently, scaling and root planning (SRP) by ultrasonic scalers (Cavitron Jet Plus
      (Densply Sirona, Mississauga, Canada) and Gracey curettes (Hu-Friedy, Chicago, USA), under
      local anesthesia, were performed by a periodontist, who was also blinded about the smoking
      status. The number of SRP visits was determined by patient disease conditions.

      Following the completion of NSPT, all subjects were recalled after one month and three months
      for re-evaluation. The collection of (1) saliva, (2) gingival cervical fluid (GCF), and (3)
      clinical periodontal parameters were performed. Based on the patients' periodontal status,
      supragingival scaling and polishing were given.
    

Intervention name(s): Nonsurgical periodontal treatment
Intervention type(s): Procedure
Intervention description(s): Oral hygiene instructions, scaling and root planning.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: periodontitis; smoking; neutrophil; matrix metalloproteinase-8; nonsurgical treatment