Objectives: The aim was to investigate the impact of smoking on pocket closure at 6 months after treatment of severe periodontitis, in relation to residual clinical inflammation.
Method and materials: The clinical records of deep pockets (probing depth ≥ 6 mm, n = 984) in 46 individuals with periodontitis were analyzed. Following baseline clinical assessments (Plaque Index, probing depth, clinical attachment level, and bleeding on probing), nonsurgical periodontal treatment was performed. Clinical assessments were repeated at 2 and 24 weeks after periodontal therapy. A logistic regression model using generalized estimation equations adapting the cluster robust standard errors was performed to investigate potential associations between bleeding on probing and pocket closure at posttreatment 24 weeks.
Results: Absence of bleeding at 2 weeks after nonsurgical treatment related to pocket closure after 6 months. Pockets that do not bleed either at baseline or at 2 weeks (OR = 2.7; P .005) and pockets of nonsmokers (OR = 6.32; P .001) and females (OR = 1.79; P = .022) associated with pocket closure at 6 months.
Conclusion: Pocket closure is associated with being a nonsmoker and the absence of inflammation after nonsurgical periodontal treatment, which indicates the importance of smoking cessation and inflammation control in achieving optimal clinical outcomes.
Keywords: bleeding, inflammation, initial treatment, maintenance, periodontitis, smoking