This retrospective study compares the short-term (1 year) and long-term (2 to 5 year) clinical results of regenerative therapy in clinical private practice using a bone allograft for the treatment of intrabony defects in smokers and non-smokers. A total of 110 intrabony lesions were treated with demineralized freeze-dried bone allograft (DFDBA) following thorough defect debridement and root preparation in 53 patients (15 cigarette smokers and 38 non-smokers). Assessments of clinical attachment level (CAL) and probing depth (PD) were recorded at pre-treatment, 1 year post-treatment, and 2 to 5 years post-treatment. At 1 year post-treatment, significant gains in mean CAL were maintained for both smokers (2.7 mm) and non-smokers (3.4 mm). Similarly, significant reductions in mean PD were observed for smokers (3.0 mm) and non-smokers (3.8 mm) at the 1-year follow-up. However, when comparing relative improvements in clinical measures, smokers were found to exhibit significantly poorer treatment results (i.e., sites exhibited less CAL gain) at 1 year and 2 to 5 years follow-up. Relative to pre-treatment scores, differences in improvements observed for CAL at the 1-year evaluation (29.2% for smokers and 42.5% for non-smokers) were sustained in the subgroup of patients at 2 to 5 years follow-up (31.3% for smokers and 41.8% for non-smokers). Similar but non-significant trends were observed for relative reductions in probing depth for smokers and non-smokers at 1 year (41.9% for smokers and 49.3% for non-smokers) and 2 to 5 years follow-up (43.9% for smokers and 48.3% for non-smokers) for the subgroup of patients followed beyond 1 year. These results suggest that smoking adversely affects treatment outcome, as measured by gains in clinical attachment levels of intrabony defects treated by regenerative therapy using DFDBA.

This case report demonstrates that orthodontic-regenerative combined therapy can resolve complex clinical problems involving several dental disciplines.

This case report demonstrates that orthodontic-regenerative combined therapy can resolve complex clinical problems and enhance predictability.

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