Non surgical therapy:
Numerous studies have indicated that current smokers do not respond as well to periodontal therapy as non-smokers or former smokers.
The majority of clinical research supports the observation that pocket depth reduction is more effective in non- smokers than in smokers using non-surgical periodontal therapy.
In addition, gains in clinical attachments as a result of scaling and root planning are less pronounced in smokers than in non- smokers.
Surgical therapy and implants
The less favorable response of the periodontal tissues to non- surgical therapy that is observed in current smokers also appears to apply to the surgical therapy.
1) Decreased pocket depth reduction and increased deterioration of furcation post surgery.
2) Impact of smoking on the success of implants
Studies by Bain CA & Moy PK in 1993, De Bruyn H & Collaert B in 1994 and Gorman LM and Lambert PM in 1994 have shown that implant success rates are reduced in smokers.
However, with existing evidence supporting a negative effect of smoking on long term implant success, patients should be informed and warned of the potential risks of smoking for implant failure.
Antimicrobial Therapy in Smokers
1.Soder et al, 1999 – Little adjunctive benefit of systemic metronidazole on non – surgical therapy in smokers.
2.Winkel et al, 2001 – Locally delivered minocycline microspheres enhanced results of mechanical therapy.
3.Williams et al, 2001 – Adjunctive systemic amoxicillin and metronidazole enhanced results of mechanical therapy.
4.Enhanced results could be due to antimicrobial actions, in cases of tetracycline derivatives, anticollagenase acitivity.
5.Novak et al, 2002 – Positive response to Periostat therapy in combination with SRP (Scaling and Root Planing) in smokers with periodontitis.
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