The impact of smoking on non‐surgical periodontal therapy: A systematic review and meta‐analysis

Chang, Jennifer; Meng, Hsiu-Wan; Lalla, Evanthia; Lee, Chun‐Teh

doi:10.1111/jcpe.13384

Cited by 26 publications

(25 citation statements)

References 93 publications

(154 reference statements)

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“…Several patient-related factors such as smoking status [54], self-performed plaque control [55], and adherence to a SPT regime [56] have been proven to influence the outcomes of NSPT. Smokers respond less favorably to periodontal therapy with less PPD reduction and CAL gain than non-smokers [57,58]. In the present study, only one article clearly excluded smokers [38].…”

Section: Discussionmentioning

confidence: 80%

Enamel matrix derivative as adjunctive to non-surgical periodontal therapy: a systematic review and meta-analysis of randomized controlled trials

et al. 2022

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Objectives To assess the potential additional benefit of the local application of enamel matrix derivative (EMD) on the clinical outcomes following non-surgical periodontal therapy (NSPT) (steps 1 and 2 periodontal therapy). Materials and Methods A systematic literature search was performed in several electronic databases, including Medline/PubMed, Embase, The Cochrane Register of Central Trials (CENTRAL), LILACS, and grey literature. Only randomized controlled clinical trials (RCTs) were eligible for inclusion. Clinical attachment level (CAL) change (primary outcome), probing pocket depth (PPD), and bleeding on probing (BoP) reductions (secondary outcomes) were evaluated. The Cochrane Risk of Bias tool (RoB 2.0) was used to assess the quality of the included trials. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) between test and control sites were estimated using a random-effect model for amount of mean CAL and PPD change. Results Six RCTs were included for the qualitative analysis, while data from 4 studies were used for meta-analysis. Overall analysis of CAL gain (3 studies) and PPD reduction (4 studies) presented WMD of 0.14 mm (p = 0.74; CI 95% − 0.66; 0.94) and 0.46 mm (p = 0.25; CI 95% − 0.33; 1.26) in favor of NSPT + EMD compared to NSPT alone respectively. Statistical heterogeneity was found to be high in both cases (I2 = 79% and 87%, respectively). Conclusions Within their limitations, the present data indicate that the local application of EMD does not lead to additional clinical benefits after 3 to 12 months when used as an adjunctive to NSPT. However, due to the high heterogeneity among the studies, additional well-designed RCTs are needed to provide further evidence on this clinical indication for the use of EMD. Clinical relevance The adjunctive use of EMD to NSPT does not seem to additionally improve the clinical outcomes obtained with NSPT alone.

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Section: Discussionmentioning

confidence: 80%

Enamel matrix derivative as adjunctive to non-surgical periodontal therapy: a systematic review and meta-analysis of randomized controlled trials

et al. 2022

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“…The smokers in the present study had worse periodontal clinical parameters than the nonsmokers, which is consistent with the findings of several studies. 40,41 In the current study, there was an improvement in periodontal outcomes after periodontal therapy in both the smokers and the nonsmokers, but the response was higher in the nonsmokers than the smokers. When comparing periodontal parameters six weeks after nonsurgical periodontal therapy in the nonsmokers versus the smokers, there was a considerable reduction in PI and PD in the nonsmokers compared to the smokers.…”

Section: Discussionmentioning

confidence: 46%

“…These results are in line with a previous report, reflecting the significant impact of smoking on periodontal tissues and the response to periodontal therapy. 41 We hypothesized that there would be no significant difference in the DKK1 serum levels in smokers and nonsmokers with periodontitis after nonsurgical periodontal therapy. However, there was a significant decrease in DKK1 serum levels after nonsurgical periodontal therapy at six weeks in both the smokers and the nonsmokers, but there was no significant difference between the two groups.…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Nonsurgical Periodontal Therapy on Serum Levels of Dickkopf-Related Protein-1 in Smokers and Nonsmokers with Periodontitis: A Prospective Comparative Study

Azab¹,

Attia²,

Yaghmoor³

et al. 2022

CCIDE

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This study aimed to evaluate and compare Dickkopf-related protein-1 (DKK1) serum levels and periodontal clinical parameters of smokers and nonsmokers with periodontitis at baseline and after nonsurgical periodontal treatment. Patients and Methods: A prospective comparative study was conducted among 24 patients with periodontitis who were divided according to the smoking habits into two groups: nonsmokers (G1) and smokers (G2). All the participants were assessed clinically by recording the probing depth (PD), clinical attachment loss (CAL), plaque index (PI), and bleeding index (BI), and immunologically by measuring the DKK1 serum levels at baseline and six weeks after nonsurgical periodontal therapy. Results:The two groups showed a significant decrease in PI, BI, and CAL after periodontal therapy (p < 0.05), while PD was significantly reduced in G1 (p = 0.005). The PI mean value was significantly higher at the baseline in G2 versus G1 (p = 0.050), while PD, BI, and CAL values were not significantly different between the groups (p = 0.056, p = 0.241, and p = 0.381, respectively). For DKK1 serum levels, there was a statistically significant decrease after treatment compared to the baseline for both groups (G1: p < 0.001; G2: p < 0.001) but no significant difference before (p = 0.131) and six weeks after treatment (p = 0.334) between the two groups. Conclusion:Although nonsurgical periodontal treatment effectively improved periodontal clinical parameters and reduced DKK1 serum levels, there were no significant differences in the DKK1 serum levels among the smokers and nonsmokers with periodontitis.

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“…Non-surgical periodontal treatment (NSPT) using hand instruments such as ultrasonic scalers and curettes is commonly performed for the treatment of periodontal inflammatory conditions such as gingivitis and periodontitis [ 2 ]. Smoking habits negatively impact clinical responses to surgical and NSPT [ 10 , 11 ]; however, with emphasis on vaping, ALHarthi et al [ 2 ], reported that ENDS-users and non-smokers respond favorably to NSPT in terms of reduction in clinical periodontal inflammatory parameters (probing depth (PD], gingival index (GI), clinical attachment loss (CAL), plaque index (PI)) compared with CS. This reflects that a consensus is yet to be reached regarding the influence of NSPT on the treatment of periodontal diseases among individuals using ENDS.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Whole Salivary Cortisol and Interleukin 1-Beta Levels in Light Cigarette-Smokers and Users of Electronic Nicotine Delivery Systems before and after Non-Surgical Periodontal Therapy

Alhumaidan

Al‐Aali

Vohra

et al. 2022

IJERPH

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There are no studies that have compared whole salivary cortisol (CL) and interleukin 1-beta (IL-1β) levels in cigarette-smokers (CS) and electronic nicotine delivery systems (ENDS)-users before and after non-surgical periodontal therapy (NSPT). The aim was to compare whole salivary CL and IL-1β levels in light CS and ENDS users before and after non-surgical periodontal therapy (NSPT). Self-reported current CS, ENDS users, and non-smokers were included. A questionnaire was used to collect demographic data. All patients underwent NSPT. Periodontal parameters (probing depth (PD], gingival index (GI], clinical attachment loss (AL], plaque index (PI], and marginal bone loss (MBL]) and whole salivary CL and IL-1β were measured at baseline. At 3-months of follow-up, clinical parameters and whole salivary CL and IL-1β were re-assessed. p-values < 1% were arbitrated as statistically significant. Fifty-four individuals (18 CS, 18 ENDS users, and 18 non-smokers) were included. Clinical AL, MT, PD, PI, and MBL were similar in all groups at baseline. At 12-weeks of follow-up, PI (p < 0.01) and PD (p < 0.01) were high in CS and ENDS-users than non-smokers. Among non-smokers, there was a statistically significant correlation between whole salivary cortisol and IL-1β levels at 12-weeks’ follow-up (p < 0.001). There was no difference in whole salivary cortisol and IL-1β levels in CS and ENDS users at baseline and at 12-weeks follow-up. At 12-weeks of follow-up, there was a significant reduction in IL-1β (p < 0.01) and CL (p < 0.01) than baseline. In light CS and ENDS users without periodontal disease, clinical periodontal parameters and whole-salivary CL and Il-1β levels remain unchanged after NSPT.

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The impact of smoking on non‐surgical periodontal therapy: A systematic review and meta‐analysis

Cited by 26 publications

References 93 publications

Enamel matrix derivative as adjunctive to non-surgical periodontal therapy: a systematic review and meta-analysis of randomized controlled trials

Enamel matrix derivative as adjunctive to non-surgical periodontal therapy: a systematic review and meta-analysis of randomized controlled trials

The Impact of Nonsurgical Periodontal Therapy on Serum Levels of Dickkopf-Related Protein-1 in Smokers and Nonsmokers with Periodontitis: A Prospective Comparative Study

Comparison of Whole Salivary Cortisol and Interleukin 1-Beta Levels in Light Cigarette-Smokers and Users of Electronic Nicotine Delivery Systems before and after Non-Surgical Periodontal Therapy

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