Smoking negatively impacts the clinical, microbiological, and immunological treatment response of young adults with Grade C periodontitis.

Abstract

This study aimed to investigate the influence of smoking on clinical, microbiological and immunological parameters in young adult with stage III-IV Grade C periodontitis after full-mouth ultrasonic debridement (FMUD) associated with Amoxicillin and Metronidazole (AMX + MTZ), comparing smokers (PerioC-Y-Smk) with non-smokers (PerioC-Y-NSmk). Fifteen PerioC-Y-NSmk and 14 PerioC-Y-Smk patients underwent FMUD associated with AMX + MTZ for 10 days. All parameters were collected at baseline and 3 and 6months after treatment. Plaque index (PI), bleeding on probing (BoP), probing depth (PD), clinical attachment level (CAL)- the primary variable-, and gingival recession (GR) were clinically assessed. The impact of PI on CAL change at 6-month was verified by a regression analysis. Samples of the subgingival biofilm was collected for detection of levels of Aggregatibacter actinomycetemcomitans (A.actinomycetemcomitans), Porphyromonas gingivalis (P.gingivalis), Tannerella forsythia (T.forsythia), and Fusobacterium nucleatum ssp (F.nucleatum), and were analyzed by real-time qPCR; gingival crevicular fluid was collected for detection of levels of interleukin (IL)-1β, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ, which were analyzed using an enzyme immunoassay. PerioC-Y-Smk had significantly higher PI, BOP, and GR at baseline compared to non-smokers (p< .05). PerioC-Y-Smk presented higher PD, CAL, and GR at 3 and 6months (p<.05) compared with PerioC-Y-NSmk in the same periods; PI negatively affected CAL gain in PerioC-Y-NSmk at 6-month follow-up (p=.052) and did not impact on clinical response in PerioC-Y-Smk (p=.882). Lower levels of IFN-γ, IL1-β, and IL-4 were observed at 3months in the PerioC-Y-NSmk (p<.05) compared with PerioC-Y-Smk. Lower proportions of P.gingivalis were observed in PerioC-Y-NSmk at baseline and at 3months (p<.05) and lower proportions of F.nucleatum were observed at 6months, in the PerioC-Y-NSmk (p<.05). PerioC-Y-Smk presents an unfavorable clinical, microbiological, and immunological response after 3 and 6months after FMUD associated with AMX + MTZ. Smoking worsens periodontal condition of young treated adults presenting stage III/IV Grade C periodontitis.