Effects of Smoking on Clinical and Microbiological Response in Individuals With Periodontitis

NCT06383455 | Completed

• 1 other identifier: Observational
• Study Type: observational
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

This study aimed to compare the distribution of subgingival periodontal pathogens following non-surgical periodontal therapy in smoking and non-smoking people with periodontitis. The main question it aims to answer is: \- Does smoking affect the results of non-surgical periodontal treatment on subgingival flora in participants with periodontal disease? Researchers performed non-surgical periodontal therapy on 48 participants with stage III/IV periodontitis and recorded clinical measurements. They obtained subgingival plaque samples from periodontal pockets at the onset and after four weeks of treatment, determining the level of periodontopathogens using a polymerase chain reaction-based method.

Conditions

Periodontitis; Smoking Habit; Subgingival Plaque

Outcome Measures

Primary Outcomes (1)

• Change in levels of periodontopathogens in subgingival plaque after non-surgical periodontal therapy in smokers and non-smokers with stage 3/4 periodontitis

  The baseline levels of periodontopathogens (P. gingivalis, A. actinomycetemcomitans, T. forsythia, F. nucleatum, P. intermedia, T. denticola, P. micra, C. rectus, E. nodatum, Capnocytophaga spp, and E. corrodens), post-treatment levels, and elimination levels with treatment were evaluated using multiplex polymerase chain reaction (PCR) analysis.The observed rates of microorganisms were assessed by determining six main levels. 0: No colouring (\<1% no bacteria) 1. Very light-colored staining (Determination of bacteria from 1% to 20%). 2. Light colored staining (Determination of bacteria from 21% to 40%), 3. Moderate colored staining (Determination of bacteria from 41% to 60%), 4. Dark colored staining (Determination of bacteria from 61% to 80%), 5. Very dark-colored staining (Determination of bacteria from 81% to 100%).

  Baseline and four weeks after the periodontal therapy.

Secondary Outcomes (5)

• Change in clinical attachment level (CAL)

  Baseline and 4 weeks after periodontal therapy

• Change in probing depth (PD)

  Baseline and 4 weeks after periodontal therapy

• Change in gingival index (GI) scores

  Baseline and 4 weeks after periodontal therapy

• Change in plaque index (PI) scores

  Baseline and 4 weeks after periodontal therapy

• Change in Bleeding on Probing (BOP)

  Baseline and 4 weeks after periodontal therapy

Study Arms (2)

Smoking individuals with periodontitis

The participants were divided into two groups according to self-reported smoking habits. The smoker group consisted of individuals with stage 3/4 periodontitis who smoked at least ten cigarettes per day for at least five years.

Procedure: Non-surgical periodontal therapy

Non-smoking individuals with periodontitis

The non-smoker group consisted of individuals with Stage 3/4 periodontitis who had never smoked in a lifetime or had quit smoking at least two years ago.

Procedure: Non-surgical periodontal therapy

Interventions

Non-surgical periodontal therapy PROCEDURE

An ultrasonic device (Cavitron Plus, Dentsply®, Duisburg, Germany) and periodontal hand instruments (periodontal curettes; Chicago, IL) were used for non-surgical periodontal treatment. The treatment procedure also included detailed oral hygiene instructions and full-mouth scaling and root planing. Scaling and root planing (SRP) was applied to all four quadrants under local anesthesia in a single appointment. No medication or mouthwash was prescribed to the patients.

Non-smoking individuals with periodontitis; Smoking individuals with periodontitis

Eligibility Criteria

• Age: 35 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population consisted of a total of 48 systemically healthy adults who applied to the Trakya University Faculty of Dentistry with periodontal complaints. The participants had generalized stage III/IV periodontitis, determined according to the criteria stated by the 2017 World Workshop for the Classification of Periodontal Diseases and Conditions. These participants were divided into two groups according to self-reported smoking habits.

You may qualify if:

• Having 15 or more permanent teeth (except third molars and teeth with endodontic lesions),
• Having been diagnosed with generalized Stage III or IV periodontitis that progresses with periodontal support tissue loss in more than 30% of the teeth,
• Having at least five teeth with probing depth(PD) ≥6mm, clinical attachment level(CAL) ≥5mm, and radiographic bone loss that extends to at least the middle of the root,
• Having at least one tooth that meets the same PD and CAL criteria per quadrant.

You may not qualify if:

• Pregnancy or lactation,
• Any systemic disease with a potential influence on the immune response (diabetes mellitus, bone metabolic diseases, immunosuppressive therapy, radiation etc.),
• Existence of decay, restoration, or prosthesis on the sampling site,
• Use of the anti-inflammatory drug and antibiotic within the last 3 months.

Sponsors & Collaborators

• Trakya University: lead

Study Sites (1)

Trakya University

Edirne, 22030, Turkey (Türkiye)

Location

Related Publications (7)

• Kubota M, Tanno-Nakanishi M, Yamada S, Okuda K, Ishihara K. Effect of smoking on subgingival microflora of patients with periodontitis in Japan. BMC Oral Health. 2011 Jan 5;11:1. doi: 10.1186/1472-6831-11-1.

  PMID: 21208407 BACKGROUND

• Van der Velden U, Varoufaki A, Hutter JW, Xu L, Timmerman MF, Van Winkelhoff AJ, Loos BG. Effect of smoking and periodontal treatment on the subgingival microflora. J Clin Periodontol. 2003 Jul;30(7):603-10. doi: 10.1034/j.1600-051x.2003.00080.x.

  PMID: 12834497 BACKGROUND

• Labriola A, Needleman I, Moles DR. Systematic review of the effect of smoking on nonsurgical periodontal therapy. Periodontol 2000. 2005;37:124-37. doi: 10.1111/j.1600-0757.2004.03793.x. No abstract available.

  PMID: 15655029 BACKGROUND

• Grossi SG, Zambon J, Machtei EE, Schifferle R, Andreana S, Genco RJ, Cummins D, Harrap G. Effects of smoking and smoking cessation on healing after mechanical periodontal therapy. J Am Dent Assoc. 1997 May;128(5):599-607. doi: 10.14219/jada.archive.1997.0259.

  PMID: 9150643 BACKGROUND

• Darby IB, Hodge PJ, Riggio MP, Kinane DF. Clinical and microbiological effect of scaling and root planing in smoker and non-smoker chronic and aggressive periodontitis patients. J Clin Periodontol. 2005 Feb;32(2):200-6. doi: 10.1111/j.1600-051X.2005.00644.x.

  PMID: 15691352 BACKGROUND

• Haffajee AD, Yaskell T, Torresyap G, Teles R, Socransky SS. Comparison between polymerase chain reaction-based and checkerboard DNA hybridization techniques for microbial assessment of subgingival plaque samples. J Clin Periodontol. 2009 Aug;36(8):642-9. doi: 10.1111/j.1600-051X.2009.01434.x. Epub 2009 Jun 26.

  PMID: 19563330 BACKGROUND

• Acikgoz-Alparslan E, Eryildiz C, Inanc B. Effects of Smoking on Clinical and Microbiological Response Following Non-Surgical Periodontal Treatment in Periodontitis Patients. Int J Dent Hyg. 2025 Nov 25. doi: 10.1111/idh.70007. Online ahead of print.

  PMID: 41290565 DERIVED

Biospecimen

Retention: SAMPLES WITHOUT DNA

Subgingival microbial dental plaque samples

MeSH Terms

Conditions

Periodontitis; Smoking

Condition Hierarchy (Ancestors)

Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Behavior

Study Officials

• Ece Açıkgöz-Alparslan

  Trakya University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assisstant Professor

Study Record Dates

• First Submitted: April 18, 2024
• First Posted: April 25, 2024
• Study Start: September 15, 2018
• Primary Completion: February 1, 2019
• Study Completion: March 1, 2019
• Last Updated: April 25, 2024

Record last verified: 2024-04

Locations

TU (1)