Effect of smoking cessation on non-surgical periodontal therapy: results after 24 months.

AIM: The aim of this 24-month prospective study was to assess the effect of smoking cessation on non-surgical periodontal therapy (NSPT) in adult subjects with chronic periodontitis. MATERIALS AND METHODS: Relative to a previous 12-month follow-up study, recruitment and follow-up period were extended, resulting in 116 eligible among the 286 screened subjects. They received NSPT and concurrent smoking cessation interventions. Periodontal maintenance was performed every 3 months. A calibrated examiner, blinded to smoking status, performed full-mouth periodontal examination in six sites per tooth at baseline, 3, 12 and 24 months of follow-up. Expired air carbon monoxide concentration measurements and interviews were performed to gather demographic and behavioural information. RESULTS: From the 116 enrolled subjects, 61 remained up to 24 months of follow-up. Of these, 18 quit smoking (Q), 32 continued smoking (NQ) and 11 oscillated (O) at 24 months of follow-up. Thereby, Q showed significantly higher mean CAL gain in diseased sites and higher reduction in the proportion of sites with CAL ≥ 3 mm, when compared to NQ. In addition, Q presented significantly higher mean probing depth reduction relative to NQ(p ≤ 0.05). CONCLUSION: Smoking cessation promoted additional benefits on NSPT in chronic periodontitis subjects.

Effects of smoking cessation on the outcomes of non-surgical periodontal therapy: a systematic review and individual patient data meta-analysis.

AIM: To conduct an individual patient data (IPD) meta-analysis to assess the effect of smoking cessation (SC) on clinical outcomes following the non-surgical periodontal treatment in patients with chronic periodontitis. METHODS: MEDLINE, EMBASE and CENTRAL were searched up to, and including, August 2012. Prospective cohort studies of at least 6 months' duration were included if the participants met the following criteria: (1) smokers who had expressed an interest in quitting the habit; and (2) a diagnosis of periodontitis. Search was conducted by two independent reviewers. IPD meta-analyses were undertaken using multiple linear or Poisson regression to evaluate the impact of SC on five different dependent variables. RESULTS: Of 2455 potentially eligible articles, two studies were included. The two studies found that SC seems to promote additional beneficial effects in reducing probing depths (PD) and improving attachment level following non-surgical periodontal treatment. The IPD approach allowed data combination but it might not have usefully added strength to the data in this review. CONCLUSION: SC seems to be an important component of periodontal therapy, and smokers should be encouraged to quit as part of their overall periodontal management; however, only a limited base of evidence was available for analysis.

A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters.

AIM: The aim of this 12-month prospective study was to assess the adjunctive effect of smoking cessation in non-surgical periodontal therapy of subjects with severe chronic periodontitis. MATERIALS AND METHODS: Of the 201 subjects enrolled from a smoking cessation clinic, 93 were eligible and received non-surgical periodontal treatment and concurrent smoking cessation treatment. Periodontal maintenance was performed every 3 months. Full-mouth periodontal examination in six sites per tooth was performed by a calibrated examiner, blinded to smoking status, at baseline, 3, 6 and 12 months after non-surgical periodontal treatment. Furthermore, expired air carbon monoxide concentration measurements and interviews based on a structured questionnaire were performed in order to collect demographic and smoking data. RESULTS: Of the 93 eligible subjects, 52 remained in the study after 1 year. Of these, 17 quit smoking and 35 continued smoking or oscillated. After 1 year, only quitters presented significant clinical attachment gain (p=0.04). However, there were no differences between the groups regarding clinical attachment level, probing depth, bleeding on probing and plaque index after 1 year (p>0.05). CONCLUSION: Smoking cessation promoted clinical attachment gain in chronic periodontitis subjects from a smoking cessation clinic after 1 year of follow-up.

Treatment of multiple recessions with collagen matrix versus connective tissue: a randomized clinical trial.

The objective of this study was to determine whether collagen matrix (CM) is an alternative to connective tissue graft technique (CTG) in the treatment of multiple gingival recessions (GR). The indication of CM for the treatment of multiple GR is not yet clear. More studies are needed to better understand this treatment modality, as an alternative to CTG. In this single-blind, split-mouth randomized clinical trial, fifteen patients with multiple Miller class I upper GR were selected and randomly assigned to control group (CTG) or test group (CM). Root coverage (RC) and patient-centered outcomes were evaluated at baseline and after 3, 6, and 12 months. A total of 82 GRs were treated. There was no significant difference regarding GR depth (GRD, primary outcome) between CTG (0.5 ± 0.9 mm) and CM groups (0.6 ± 1.0 mm) (p = 0.225). Percentage of RC was 82.14% in CTG and 77.7% in CM. Both groups demonstrated a gain in keratinized tissue width at 12 months (p < 0.05). Dentine hypersensitivity was effectively reduced in both groups. Postoperative pain was significantly higher in the CTG (p = 0.001). Esthetic satisfaction was high for both groups, with no significant difference (p > 0.05) between groups. After 12 months, both surgical treatments were able to promote RC, and GRD was similar in both CTG and CM groups.

Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study.

The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

Treatment of multiple recessions with collagen matrix versus connective tissue: a randomized clinical trial

Abstract The objective of this study was to determine whether collagen matrix (CM) is an alternative to connective tissue graft technique (CTG) in the treatment of multiple gingival recessions (GR). The indication of CM for the treatment of multiple GR is not yet clear. More studies are needed to better understand this treatment modality, as an alternative to CTG. In this single-blind, split-mouth randomized clinical trial, fifteen patients with multiple Miller class I upper GR were selected and randomly assigned to control group (CTG) or test group (CM). Root coverage (RC) and patient-centered outcomes were evaluated at baseline and after 3, 6, and 12 months. A total of 82 GRs were treated. There was no significant difference regarding GR depth (GRD, primary outcome) between CTG (0.5 ± 0.9 mm) and CM groups (0.6 ± 1.0 mm) (p = 0.225). Percentage of RC was 82.14% in CTG and 77.7% in CM. Both groups demonstrated a gain in keratinized tissue width at 12 months (p < 0.05). Dentine hypersensitivity was effectively reduced in both groups. Postoperative pain was significantly higher in the CTG (p = 0.001). Esthetic satisfaction was high for both groups, with no significant difference (p > 0.05) between groups. After 12 months, both surgical treatments were able to promote RC, and GRD was similar in both CTG and CM groups.

Smoking and periodontal tissues: a review.

The impact of smoking on general health has been widely studied and is directly related to several important medical problems including cancer, low birth weight, and pulmonary and cardiovascular disease. In the past 25 years, there has also been an increasing awareness of the role of cigarette consumption in oral health problems such as periodontal disease. Smoking is considered the major risk factor in the prevalence, extent and severity of periodontal diseases. This article will discuss the available evidence and provide the reader with an overview of the impact of smoking and its cessation on the pathogenesis and treatment of periodontal diseases.

Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study

Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

Smoking and periodontal tissues: a review

The impact of smoking on general health has been widely studied and is directly related to several important medical problems including cancer, low birth weight, and pulmonary and cardiovascular disease. In the past 25 years, there has also been an increasing awareness of the role of cigarette consumption in oral health problems such as periodontal disease. Smoking is considered the major risk factor in the prevalence, extent and severity of periodontal diseases. This article will discuss the available evidence and provide the reader with an overview of the impact of smoking and its cessation on the pathogenesis and treatment of periodontal diseases.

Variação da técnica do túnel para o recobrimento radicular em áreas estéticas: relato de dois casos / Variation of the tunnel technique for root coverage in the aesthetic areas: report of two cases

Este relato de caso descreve uma variação da técnica de túnel, associada ao enxerto de tecido conjuntivo subepitelial, para o recobrimento radicular de retrações gengivais (RG) múltiplas adjacentes em área estética. Este procedimento foi utilizado em dois casos clínicos distintos com o objetivo de conseguir recobrimento radicular, diminuição de hipersensibilidade dentinária e aumento da faixa de gengiva inserida. No caso 1, havia RGs, Classe I de Miller, nos dentes 11, 21 e 22, e todos os objetivos foram alcançados. No caso 2, as RGs eram Classe III de Miller nos dentes 11 e 21, e houve aumento da faixa de gengiva inserida, ganho de inserção clínica e recobrimento radicular parcial em ambos os dentes. A variação da técnica de túnel associada ao enxerto de tecido conjuntivo subepitelial pode ser uma alternativa viável para o tratamento das RGs Classes I e III de Miller, e sua utilização pode melhorar o padrão estético, promover ganho de inserção clínica, aumento da faixa de gengiva inserida e recobrimento radicular