Periodontal Disease in Habitual Cigarette Smokers and Nonsmokers With and Without Prediabetes

Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration (FJ, MA-A, KA-H), College of Applied Medical Sciences
The American Journal of the Medical Sciences (Impact Factor: 1.39). 06/2012; 345(2). DOI: 10.1097/MAJ.0b013e31824d5337
Source: PubMed


: Prediabetes and habitual cigarette smoking are significant risk factors contributing to periodontal disease. The aim was to assess the clinical and radiological markers of periodontal disease in habitual cigarette smokers and nonsmokers with and without prediabetes.

Sixty-eight individuals with prediabetes (test group; 34 smokers and 34 nonsmokers) and 68 medically healthy individuals (control group; 34 smokers and 34 nonsmokers) were included. Sociodemographic information, duration of smoking habit and number of cigarettes smoked daily were recorded through a questionnaire. Fasting blood glucose levels and periodontal inflammatory conditions (plaque index [PI], bleeding on probing [BOP] and probing pocket depth [PPD] of 4 to <6 mm and ≥6 mm) were recorded. In both groups, marginal bone loss (MBL) was measured on digital panoramic radiographs.

Cigarette smokers and nonsmokers in the test group had significantly higher fasting blood glucose level when compared with cigarette smokers in the control group (P < 0.001). In the test group, there was no significant difference in PI, BOP, PPD (4 to <6 mm and ≥6 mm) and MBL among cigarette smokers and nonsmokers. Cigarette smokers in the control group had significantly higher PI (P < 0.001), PPD (4 to <6 mm; P < 0.001), PPD ≥6 mm (P < 0.01) and MBL (P < 0.05) than nonsmokers. BOP was significantly reduced in smokers when compared with nonsmokers in the control group (P < 0.001).

Cigarette smokers without prediabetes exhibit significantly severe periodontal disease than nonsmokers. In subjects with prediabetes, the severity of periodontal disease seems to be over shadowed by the hyperglycemic state, obscuring the effect of habitual smoking.

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    • "al tissues of smokers ( Katz et al . , 2005 ) ; which induces a proin - flammatory effect by stimulating the secretion of cytokines and reactive oxygen species ( ROS ) . This in turn causes destruction of the periodontal apparatus ( Katz et al . , 2005 , 2007 ) . Results by Tanaka et al . ( 2013 ) are in accordance with previous clinical studies ( Javed et al . , 2007 , 2012 , 2013 ) . It is known that severity of periodontal disease is directly asso - ciated with duration and intensity / frequency of smoking ( Salem et al . , 2008 ) . This is an essential parameter that remained poorly addressed in the studies ( Numabe et al . , 1998 ; Arbes et al . , 2001 ; Yamamoto et al . , 2005 ; Nishida et al . , 2006 , 2008"
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