RESUMEN
Objetivo: o propósito deste estudo foi avaliar, através da revisão de literatura, os aspectos clínicos (índice de placa, índice gengival, profundidade de sondagem, recessão gengival e nível clínico de inserção) e microbiológicos (presença qualitativa e quantitativa de periodontopatógenos) e a resposta de pacientes tabagistas à terapia periodontal. Material e Métodos: foram selecionados artigos científicos publicados entre os anos de 1978 a 2014, através dos bancos de dados MEDLINE, PUBMED e LILACS. Resultados: existem divergências em relação à influência do tabagismo nos parâmetros clínicos e microbiológicos. Conclusão: baseado nos estudos avaliados pode-se concluir que há diferenças clínicas e microbiológicas significativas no paciente tabagista e comprometimento da resposta à terapia periodontal.
Objective: the aim of this study was to evaluate, through literature review, clinical aspects (plaque index, gingival index, probing depth, gingival recession and clinical attachment level) and microbiological (qualitative and quantitative presence of periodontal pathogens) in smokers patients and the response to periodontal therapy. Material and Methods: it was selected scientific articles published between the years 1978 and 2014. We were selected scientific articles from MEDLINE, PUBMED and LILACS databases. Results: there are controversies between tobacco and clinical and microbiological parameters. Conclusion: based on the evaluated studies we can conclude that there are significant clinical and microbiological differences in smoking patients and impaired response to periodontal therapy.
RESUMEN
Abstract This pilot study aimed to evaluate the influence of smoking on clinical and microbiological parameters after nonsurgical periodontal therapy. Forty-eight subjects were grouped into smokers (SM, n = 24) and nonsmokers (NS, n = 24) and paired according to gender, age, ethnicity, and periodontal status. Both groups received oral hygiene education and scaling and root planing. Clinical evaluation was performed using plaque index (PI), bleeding on probing (BOP), pocket probing depth (PPD), gingival recession (GR), and clinical attachment level (CAL) before instrumentation (baseline) and at 3 and 6 months. The prevalence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Candida albicans, Candida glabrata, Candida tropicalis, and Candida dubliniensis in subgingival biofilm was determined by polymerase chain reaction. The data were statistically analyzed considering p < 0.05. Clinical conditions improved between baseline and 3 months after periodontal treatment. However, NS had a better clinical response, presenting greater PPD reduction and CAL increase in comparison to SM. Periodontal treatment reduced the levels of P. gingivalis, A. actinomycetemcomitans, and T. forsythia individually after 3 months for the NS group and after 6 months for both groups. The prevalence of Candida species was markedly higher in SM than in NS at all time points evaluated. Periodontopathogens associated or not with C. albicans or C. dubliniensis were more prevalent in SM than in NS at baseline and after 3 months. It was concluded that smoking impairs clinical and microbiological responses to periodontal therapy. Periodontopathogens combined or not with some Candida species are resistant to short-term periodontal therapy in SM.