Periodontitis Clinical Trial
Official title:
Effect of Smoking Cessation on Clinical and Microbiological Outcomes of the Non-surgical Periodontal Therapy
The aim of this prospective interventional study is to verify the efficacy of smoking cessation on clinical and microbiological outcomes of non-surgical periodontal therapy of chronic periodontitis patients. Smokers willing to quit received periodontal treatment and concurrent smoking cessation therapy. Periodontal maintenance was performed every 3 months. A single calibrated examiner, blinded to smoking status, assessed periodontal clinical outcomes and applied a structured questionnaire in order to collect demographic and behavioural information. Further, expired carbon monoxide concentration were measured with a monoximeter. A pooled subgingival plaque sample was collected from the deepest periodontal pocket from each participant. The presence and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola were determined using (RT-PCR).
Smokers willing to quit, with 10 teeth or more, and with periodontitis (30% or more of their
teeth with proximal attachment loss ≥ 5 mm) were enrolled in the study. All subjects received
periodontal treatment and concurrent smoking cessation therapy. Smoking cessation therapy was
performed by a team comprising physicians, nurses, a psychologist and dentists, and consisted
of four 1-h counselling lectures, psychologist-assisted cognitive behavioral therapy,
nicotine replacement therapy and medication (bupropion or varenicline). Smoking cessation
motivation was reinforced by dentists at the maintenance sessions, by means of motivational
interviewing techniques. Periodontal therapy consisted in full-mouth supra and subgingival
scaling and root planing (with curettes and ultrasonic scaler); oral hygiene instruction and
motivation and removal of intra-oral plaque retentive factors. Further, periodontal
maintenance was performed every 3 months.
A single calibrated examiner, blinded to smoking status, assessed periodontal clinical
outcomes (recession, pocket depth, clinical attachment level, plaque index and bleeding on
probing). A structured questionnaire was applied in order to collect demographic and
behavioral information. Expired carbon monoxide concentration was measured with a
monoximeter, in order to validate smoking status. A pooled subgingival plaque sample was
collected from the deepest periodontal pocket from each participant. The presence and
quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella
forsythia and Treponema denticola were determined using real time - PCR (RT-PCR).
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