Does Exposure to Tobacco Smoke Modify the Clinical Periodontal Parameters After Non-Surgical Periodontal Therapy With and Without the Addition of a Chlorhexidine-Based Antiseptic? - A Controlled Clinical Trial

Abstract

Objective

To evaluate whether tobacco smoking modifies the clinical outcomes of non-surgical periodontal therapy (NSPT) in adults with periodontitis and what are the added benefits of a chlorhexidine-based antiseptic.

Methods

Sample included 60 subjects aged 24 to 75 years (median 49; 67% females) diagnosed with periodontitis; 50% of them were regular smokers. All subjects underwent clinical periodontal examination that included measuring Full Mouth Plaque Score (FMPS), Full Mouth Bleeding Score (FMBS), Pocket Depth (PD), Clinical Attachment Level (CAL), Gingival Recession (GR) and Tooth Mobility (TM). All subjects underwent NSPT. Half of the subjects in each group used a 0.12% CHX-based mouth-rinse twice a day for 15 days. Clinical examination was repeated 8 weeks after NSPT.

Results

FMPS significantly decreased after NSPT in all groups (p ≤ 0.013). FMBS was reduced in non-smokers (with and without CHX) (p ≤ 0.038) with a greater effect when using CHX. No major differences in FMBS in smokers were noted. NSPT reduced PD in all non-smokers (p ≤ 0.016) with a greater effect with CHX use; and in smokers with CHX (p ≤ 0.016). The same findings were in gain of CAL (p ≤ 0.028). The effect of NSPT on GR and TM was small. In multiple regression analysis, the use of CHX and male sex were significant predictors of a reduction in the proportion of deep pockets (≥ 5 mm), when age and exposure to tobacco smoke were controlled for (R² = 0.170; p = 0.033).

Conclusion

Smoking reduces the success of NSPT but the addition of antiseptic proved to be an additional benefit.