Objectives: The aim of this study was to determine to what extent mechanical treatment without antibiotics (surgical vs nonsurgical treatment in smoker vs nonsmoker) results in resolution of advanced periodontitis in young adults. We treated 23 subjects (mean age 34, 9 smokers...Sm, 14 nonsmokers...NSm), who had attachment losss > 5 mm on at least 8 teeth. Methods: After baseline examin (probing depth PD, attachment loss, BOP, Florida probe) instruction in oral hygiene and deep scaling under anesthesia was performed in 4 to 6 sessions (phase 1). If residual probing depth was > 5 mm 8 weeks after the last scaling session, either scaling or access flap was performed in a split mouth design (phase 2). Final examin was performed 6 months after the last scaling/surgical session. Results: Scaling (phase 1) reduced PD from 7.6 to 4.7 mm in NSm, 7.3 to 5.5 mm in Sm , 4.7 to 3.0 mm in NSm and from 4.8 to 3.7 mm in Sm (all p=0.000, paired t-test). The difference between Sm and NSm was significant (p=0.013, ANOVA). Phase 2 reduced PD>7mm in nonsmoker/scaling from 7.7 to 4.8 mm; in nonsmoker/flap 7.4 to 4.4mm; in smoker/scaling 7.5 to 4.7mm and in smoker/flap 7.3 to 5.4mm and 4 –7 mm category in nonsmoker/scaling from 4.5 to 3.6mm; in nonsmoker/flap from 4.6 to 3.6; in smoker/scaling 4.4 to 3.6mm; smoker/flap from 4.6 to 3.8mm (all p=0.000, difference between scaling and flap ns). Conclusion: The main effect in probing depth reduction was obtained in phase 1. In phase 2 there was no significant and clinically relevant difference between scaling and access flap. Both treatment regimens resulted in further improvement. It should be discussed if access flap in smokers is indicated.

Back to the Periodontal Research - Therapy Program
Back to the IADR/AADR/CADR 80th General Session (March 6-9, 2002)

Top Level Search