Cigarette smoking associated with advanced periodontal destruction in a Greek sample population of patients with periodontal disease.

OBJECTIVES: The objective of this study was to evaluate the possible risk factor related to the severity of periodontal destruction in an adult Greek population and to determine possible risk factors of chronic periodontal disease. METHODS: The 115 participants (mean age 47.5, range 28-74 years) were referred for periodontal treatment in two high-standard therapeutic centers. All individuals were clinically examined and answered a detailed questionnaire. The sociodemographic characteristics and periodontal findings were recorded and statistically analyzed. RESULTS: The prevalence of periodontal destruction was significantly high, as 91.3% of the participants had at least one tooth with attachment loss > or = 7 mm and 73% presented with mean loss of attachment > 4 mm. In this subject cohort, 31.3% had never smoked, 15.7% had quit smoking, and 53% were currently smokers (heavy, moderate, or occasional). Heavy smokers exhibited worse periodontal tissue breakdown and less bleeding tendency compared to moderate, infrequent, or never smokers. Among the other investigated parameters, age and customary oral hygiene practices were correlated with periodontal pocket formation and clinical attachment loss. CONCLUSIONS: The results of this study suggest that smoking appears to be a major environmental factor associated with accelerated periodontal destruction in an adult urban Greek population with regular oral hygiene habits.

Tetracycline fibers as an adjunct in the treatment of nifedipine-induced gingival enlargement.

BACKGROUND: The hypothesis that nifedipine-induced gingival enlargement in periodontitis patients can be treated with the adjunctive use of tetracycline (TCN) fibers was tested in this study. METHODS: Ten patients (mean age 66 +/- 4 years) with chronic periodontitis combined with nifedipine-induced gingival enlargement participated. Full mouth recordings of clinical parameters (probing depth, clinical attachment level, bleeding on probing, presence or absence of plaque) were assessed at baseline and gingival enlargement was estimated from casts. Participants were instructed in proper oral hygiene and received supragingival scaling before being reassessed 1 month later. They subsequently received full-mouth scaling and root planing followed by the immediate placement of TCN fibers in all pockets >5 mm. Clinical parameters were reassessed at 3, 6, and 12 months after completion of treatment. RESULTS: TCN fiber placement was well tolerated by patients. All clinical parameters recorded displayed significant improvements after treatment, and they were preserved for the 12-month experimental period. A significant reduction of the percentage of pockets >5 mm was noticed after treatment. The reduction of enlargement was still observed at 12 months despite patients not achieving optimal oral hygiene. CONCLUSION: Placement of tetracycline fibers as an adjunct to mechanical treatment is an option for the non-invasive therapy of nifedipine-induced gingival enlargement in periodontitis patients whose general medical condition and concomitant ailments do not favor a surgical approach.