RESEARCH – January 2006

The effect of smoking on the efficacy of combination of non-surgical and antibiotic therapies in patients with chronic periodontitis


Articles PDF


The aim of this study was to compare the longitudinal effect of combination of non-surgical periodontal therapy with systemic antibiotics in smoking and non-smoking patients.
Subjects and methods. A total of 16 patients were involved in this study: 8 smoking and 8 non-smoking patients with severe generalized chronic periodontitis, who did not respond well to previous mechanical periodontal treatment. Clinical examination included recordings of plaque, gingival indices, bleeding and suppuration after probing, probing pocket depths and probing attachment levels. Non-surgical periodontal therapy under local anaesthesia was performed by quadrants within 4 weeks. Clinical parameters were recorded at baseline, 2–3 weeks after the first mechanical treatment and 14 months after combined treatment at a regular check-up visit. As the patients did not respond to conventional periodontal therapy, microbiological  samples were taken and a combination of systemic amoxicillini 500 mg × 3 and metronidazoli 250 mg × 2 for 7 days was prescribed.
Results. The results suggested that combined systemic antibiotic therapy, based on microbiological sample, is effective in the case of severe generalized chronic periodontitis, as most clinical parameters improved significantly after the treatment. In the non-smoking group, all parameters except for suppuration improved significantly after the treatment. Despite the generally positive treatment effect, there were insignificant improvements in any clinical parameters in the smoking group. The smokers showed markedly smaller reduction in bleeding after probing and greater loss of clinical attachment.
Conclusion. As smoking has an adverse effect on periodontal therapy, the dentist should cooperate with patients in counselling for smoking cessation to achieve better results in the treatment of periodontitis.