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Effect of smoking cessation on periodontal regeneration therapies: a propensity score-matched study
Yoshito Ochiai1, Yumi Saito1,2, Misaki Matsuzaki1
1Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo, Japan.
Purpose:
Smoking adversely affects the outcomes of periodontal therapy; however, no studies have evaluated whether smoking cessation is associated with improved outcomes after periodontal regenerative therapy. This retrospective observational study with a quasi-analytical design used propensity score (PS) matching to compare postoperative outcomes between current and former smokers and to evaluate the association between smoking cessation and the outcomes of periodontal regenerative therapy.
Methods:
Data were retrospectively collected for all sites treated with periodontal regenerative therapy at Nihon University School of Dentistry at Matsudo Hospital between February 2017 and June 2024. Clinical parameters, radiographic assessments, and smoking histories were extracted from electronic medical records. After PS matching, outcomes were compared between current and former smokers. The primary outcome was radiographic bone fill (RBF), and the secondary outcomes were clinical attachment level (CAL) gain and probing depth (PD) reduction at 12 months postoperatively.
Results:
Before PS matching, 30 sites in current smokers and 25 sites in former smokers were analyzed. After matching, 15 sites from each group were included. Mean RBF was 34.4%±20.0% in current smokers and 56.5%±27.6% in former smokers. Mean CAL gain and PD reduction were 2.07±1.39 mm and 2.67±1.76 mm, respectively, in current smokers and 3.07±1.39 mm and 2.87±1.46 mm, respectively, in former smokers. In a forced-entry multivariable regression analysis, former-smoker status was associated with greater RBF at 12 months postoperatively (regression coefficient, 23.5; 95% confidence interval, 4.15-42.7). CAL gain and PD reduction did not differ significantly between current and former smokers.
Conclusions:
Although the retrospective study design required comparison of different individuals, smoking cessation was associated with 23.5 percentage points greater RBF at 12 months after periodontal regenerative therapy.