Influence of tobacco smoking on periodontal bone height. Long-term observations and a hypothesis

The aim of the investigation was to estimate the magnitude of the long-term influence of chronic smoking on the periodontal bone height.

The study population included 19 continuous smokers, 28 former smokers and 44 non-smokers in the age range 20-60 years at baseline. The participants were examined at two points in time with an interval of 10 years. The height of the periodontal bone was determined from bite-wing radiographs of the first and second premolars of the maxilla and the mandible and measured from the cemento-enamel junction (CEJ) to the periodontal bone crest (PBC) mesially and distally to the preselected teeth.

The mean (SD) CEJ-PBC distance at baseline was 1.82 (1.01) mm for smokers, 1.65 (0.81) mm for former smokers, and 1.16 (0.59) mm for non-smokers (p=0.016). The mean (SD) 10-year bone height reduction was 0.74 (0.59) mm for smokers as against 0.26 (0.31) mm for former smokers and 0.27 (0.29) mm for non-smokers. Controlling for age and baseline bone height level, the magnitude of the reduction was significantly dependent of smoking (p=0.000). The widening gap between smokers and non-smokers over time suggested that the bone height reduction of smokers took place at an accelerated rate.

On the basis of the observations it is hypothesized that smoking induces an acceleration of the periodontal bone height reduction rate and that smoking cessation results in a return towards non-smoker rate.