Abstract:
BACKGROUND:Mechanical periodontal therapy consists of a non-surgical course, followed by surgical treatment to eliminate or reduce remaining pathological pockets. Only if diligent mechanical therapy fails are additional measures considered. It has been documented that smoking interferes with the host defense mechanisms. This study addresses the question is meticulous non-surgical periodontal therapy equally successful in smokers and non-smokers? If not, is a thorough and cumbersome non-surgical approach in smokers worth undertaking? METHODS:Thirty-five smokers and 35 non-smokers were selected retrospectively from a pool of 306 patients treated in a private practice over a 17-month period. All had at least 14 teeth present with 8 presenting with gingival pockets > or =6 mm. Non-surgical treatment was performed in 6 to 10 appointments and results were evaluated 6 to 12 weeks after therapy. Bleeding on probing sites with probing depths > or =5 mm were then considered for surgical treatment. RESULTS:Before treatment smokers had statistically significantly higher mean percent of pockets 4 to 5 mm and > or =6 mm (40.36+/-10.65 and 26.51+/-11.95, respectively, compared to 30.38+/-7.57 and 20.42+/-10.03 for non-smokers) and showed significantly lower proportional reduction of these parameters with treatment (50.80+/-33.76 and 81.36+/-19.82 for pocket 4 to 5 mm and 6 mm, compared to 68.43+/-21.23 and 91.7+/-8.92 for nonsmokers). A multivariate analysis gave smoking, plaque control, and initial percent of sites > or =6 mm to be significant predictors of the percent of teeth in need of further therapy. In non-smokers, treatment was apparently successful in all tooth types with the exception of upper first and second molars (28.5% failure) and lower second molar (20% failure). In smokers, rates of further treatment needs were particularly high in the premolar-molar area in both jaws, ranging from 31.4% to 48.5% for an individual tooth type; 42.8% of smokers and 11.5% of non-smokers needed further treatment in 16% of their teeth (pretest probability). A decision analysis showed that for smokers with at least 1 of 5 sites > or =6 mm, one should initiate surgical treatment, rather than first treat non-surgically. If the point of indifference that the decision is correctly set at 95%, the pretest probability should be >12%. There is a higher risk that non-surgical therapy will fail, for instance if we lower the point of indifference to 60%, the pretest probability should be >31%. CONCLUSIONS:It is concluded that smoking impairs healing after nonsurgical periodontal therapy. The decision analysis of this study questions the need for a thorough course of non-surgical treatment in smokers with advanced periodontal disease.
journal_name
J Periodontoljournal_title
Journal of periodontologyauthors
Papantonopoulos GHdoi
10.1902/jop.1999.70.10.1166subject
Has Abstractpub_date
1999-10-01 00:00:00pages
1166-73issue
10eissn
0022-3492issn
1943-3670journal_volume
70pub_type
杂志文章abstract:BACKGROUND:Previous studies have demonstrated that enamel matrix derivative (EMD) has the ability to improve clinical parameters when used to treat intraosseous defects. The purpose of the present study was to compare at 12 months postsurgery sites treated with open flap debridement (OFD) alone to those treated with OF...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1902/jop.2001.72.1.25
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Treatment of periodontally diseased multi-rooted posterior teeth has conventionally consisted of scaling and root planing, apically positioned flaps, tunneling, root amputation, root resection, guided tissue regeneration, osseous grafting, and combination osseous graft and barrier membrane techniques. Succes...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2000.71.6.1043
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Periodontal root coverage procedures to treat recession areas are indicated for unesthetic, exposed, and/or painful root surfaces. Many methods, most using autogenous soft tissue grafts, have been utilized, but with associated morbidity at the donor sites. An alternative donor material would reduce the morbi...
journal_title:Journal of periodontology
pub_type: 临床试验,杂志文章
doi:10.1902/jop.2001.72.8.998
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:This prospective and controlled study elucidates the impact of smoking on the salivary microbiome and its further influence on marginal bone loss (MBL) around an implant during a 3-month bone-healing period. METHODS:Saliva samples were collected preoperatively from 20 periodontally healthy patients with sin...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2017.160808
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:To determine the level of perceived pain after different types of periodontal/oral surgical procedures, and the differences in patients' selection of pain management, over the counter (OTC) versus opioid, based on procedure type. METHODS:Patients undergoing surgical procedures were asked to complete a pain ...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1002/JPER.20-0315
更新日期:2020-11-05 00:00:00
abstract:BACKGROUND:Prostaglandin E2 (PGE2) plays important roles in the pathogenesis of periodontal disease. Recent studies have revealed the existence of 2 isozymes of cyclooxygenase (COX), called COX-1 and COX-2. The purpose of the present study was to investigate the contribution of COX-1 and COX-2 to PGE2 production by hum...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2000.71.10.1575
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Periodontal wound healing has been accelerated by different low-level laser therapy (LLLT) protocols. However, just a few studies have evaluated use of this therapy adjunctive to periodontal plastic surgery procedures. The present study shows 2-year results of a connective tissue graft (CTG) associated with ...
journal_title:Journal of periodontology
pub_type: 杂志文章,随机对照试验
doi:10.1902/jop.2016.160391
更新日期:2017-04-01 00:00:00
abstract::THE MORBIDITY and incidence of bacteremia in periodontal surgery with or without cephalexin prophylaxis were assessed in adults on the basis of clinical evaluations and blood cultures. Cephalexin reduced the incidence of polymicrobic bacteremias. There was no correlation between objective signs of tissue healing and a...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1982.53.5.319
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:Macrophages account for 5% to 30% of the inflammatory infiltrate in periodontitis and are activated by the classic and alternative pathways. These pathways are identified by indirect markers, among which interferon (IFN)-γ and interleukin-6 (IL)-6 of the classic pathway and IL-4 of the alternative pathway ha...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2013.130078
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:This study tests the effectiveness of hydroxyapatite and collagen bone blocks of equine origin (eHAC), infused with recombinant human platelet-derived growth factor-BB (rhPDGF-BB), to augment localized posterior mandibular defects in non-human primates (Papio hamadryas). METHODS:Bilateral critical-sized def...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2012.110478
更新日期:2012-07-01 00:00:00
abstract::Smoker's melanosis is a benign pigmentation of the oral mucosa, predominantly observed on the attached anterior mandibular gingiva and interdental papillae. These macular lesions are independent of genetic factors, therapeutic medication usage, and various systemic disorders. As a group they are often seen after the t...
journal_title:Journal of periodontology
pub_type: 杂志文章,评审
doi:10.1902/jop.1991.62.8.524
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Chronic periodontitis (CP) exhibits inflammation and alveolar bone loss, and severe forms of periodontitis are suggested to have a genetic basis. Vitamin D receptor (VDR) regulates bone metabolism and inflammation-related genes, and single nucleotide polymorphisms (SNPs) in the VDR gene may affect the functi...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2009.080465
更新日期:2009-04-01 00:00:00
abstract::Plasma cells are widely distributed in inflamed periodontal tissues, the adjacent periodontal ligament and nearby alveolar bone spaces, of old rats (20 and 27 months) raised on a conventional diet in a normal laboratory environment. Electron microscopy revealed three morphologic types (or perhaps stages) of these cell...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1983.54.4.227
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated that bone demineralization can improve consolidation in bone grafts. The biologic mechanisms underlying this phenomenon remain unclear. METHODS:Twelve adult male guinea pigs were used in this experiment. Forty-five bone samples removed from the calvaria of nine animals wer...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2014.130657
更新日期:2015-01-01 00:00:00
abstract::In this study, fine structural features of the pocket walls in rapidly progressive periodontitis (RPP) and adult periodontitis (AP) in 20 cases were compared using light and transmission electron microscopy. Gingiva was also obtained from a control group of periodontally healthy teeth. Clinical parameters were assesse...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1998.69.2.195
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:The peri-implant soft tissue phenotype (PSP) encompasses the keratinized mucosa width (KMW), mucosal thickness (MT), and supracrestal tissue height (STH). Numerous approaches to augment soft tissue volume around endosseous dental implants have been investigated. To what extent PSP modification is beneficial ...
journal_title:Journal of periodontology
pub_type: 杂志文章,评审
doi:10.1002/JPER.19-0716
更新日期:2021-01-01 00:00:00
abstract::A histologic review of 129 circumscribed mesenchymal lesions of the gingivae was performed. Two cases were peripheral reparative giant cell granulomas; eight were peripheral odontogenic fibromas; 41 were inflammatory hyperplasias; 68 were pyogenic granulomas; 11 were "hard fibromas"; one lesion exhibited the histologi...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1978.49.8.423
更新日期:1978-08-01 00:00:00
abstract::A National Survey of the Oral Health of U.S. children aged 5 to 17 was conducted by the National Institute of Dental Research during the 1986-87 school year. Eleven thousand and seven adolescents aged 14 to 17 years received a periodontal assessment. Their patterns of loss of periodontal attachment as assessed by prob...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1991.62.10.608
更新日期:1991-10-01 00:00:00
abstract::In order to increase our understanding of the immunologic aspects of periodontal disease, three groups of extracted human teeth were evaluated for the presence of antibody on the cementum surface. Antibody was demonstrated by direct immunofluorescence using monospecific antibody with human alpha , gamma and upsilon ch...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1982.53.3.168
更新日期:1982-03-01 00:00:00
abstract::The aim of the present investigation was to evaluate the effectiveness of collagen membrane placement in excluding gingival epithelium and connective tissue cells and guiding new attachment in surgical treatment of created defects in dogs. Sixty defects were chosen at random and balanced in regard to receiving the fol...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1988.59.12.830
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:This study compares the levels of cytokines and bone-related factors in the gingival crevicular fluid (GCF) of systemically healthy patients with chronic periodontitis (CP); and better-controlled, and poorly controlled patients with type 2 diabetes and CP. METHODS:Thirty-seven patients with type 2 diabetes ...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2011.100643
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Periodontitis is a multifactorial and infectious disease that may result in significant debilitation. The aim of this study is to exploit two optical coherence tomography (OCT) systems operating in the Fourier domain at different wavelengths, 930 and 1,325 nm, for structural analysis of periodontal tissue in...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2015.150047
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Chronic periodontitis (CP) is a multifactorial complex periodontal disease involving immune response, inflammation, alveolar bone resorption, and attachment loss. Colony stimulating factor-1 (CSF-1) controls the production, differentiation, and function of macrophages and plays a vital role in the innate imm...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2014.130688
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:We used epidemiologic data of clinical periodontal status from two population-based samples in two countries, United States and Germany, to examine 1) the impact of age on the relative contribution of recession and pocketing on the distribution of clinical attachment loss, and 2) whether it is feasible to def...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1002/JPER.17-0670
更新日期:2018-06-01 00:00:00
abstract::The greatest challenge in treatment planning is to assign an accurate prognosis and develop a predictable protocol. In the era of evidence-based dentistry, outcome studies have forced us to reexamine our treatment approaches and decide if superior treatment options should be pursued. As endosseous dental implants gain...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2008.070551
更新日期:2008-06-01 00:00:00
abstract::Cyclosporine A (CsA) and verapamil are two agents used in renal transplantation, both of which are suspected of inducing gingival overgrowth. This study was conducted to investigate the effect of verapamil on the severity and prevalence of CsA-induced gingival overgrowth. Fifty-one (51) renal transplant recipients (to...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1996.67.11.1201
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) is a major risk factor for periodontal disease and affects various cellular functions. Periodontal ligament stem cells (PDLSCs) play an important role in periodontal tissue regeneration; however, the effect of hyperglycemia on PDLSCs is unclear. The aim of this study is to investigate ...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.2015.150474
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:In sinus augmentation, when remaining bone height is ≤5 mm, a lateral window approach is often the preferred choice; nonetheless, patients prefer to have a less invasive approach such as crestal sinus augmentation (CSA). Prior case reports have described the use of various staged approaches of a CSA techniqu...
journal_title:Journal of periodontology
pub_type:
doi:10.1002/JPER.18-0632
更新日期:2020-02-01 00:00:00
abstract::The assessment of new attachment after periodontal treatment has been the focus of continuous research. An approach to longitudinally examine the deposition of cementum was devised by using fluorescence microscopy (FL), contact microradiography (CMR), and toluidine blue staining (TBS) after the injection of three labe...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1991.62.4.284
更新日期:1991-04-01 00:00:00
abstract::The present paper describes 36 consecutively treated non-human primates (Macaca mulatta) as part of a balanced block design study to examine osseointegration in root- and plate-form implants prepared by atraumatic preparation of bone. Clinical measurements around selected teeth and digital radiology were utilized to m...
journal_title:Journal of periodontology
pub_type: 杂志文章
doi:10.1902/jop.1996.67.12.1322
更新日期:1996-12-01 00:00:00