Impact of smoking on experimental gingivitis. A clinical, microbiological and immunological prospective study

J Periodontal Res. 2016 Dec;51(6):800-811. doi: 10.1111/jre.12363. Epub 2016 Mar 3.

Abstract

Objective: The present study assessed the effect of smoking on clinical, microbiological and immunological parameters in an experimental gingivitis model.

Material and methods: Twenty-four healthy dental students were divided into two groups: smokers (n = 10); and nonsmokers (n = 14). Stents were used to prevent biofilm removal during brushing. Visible plaque index (VPI) and gingival bleeding index (GBI) were determined 5- on day -7 (running phase), baseline, 21 d (experimental gingivitis) and 28 d (resolution phase). Supragingival biofilm and gingival crevicular fluid were collected and assayed by checkerboard DNA-DNA hybridization and a multiplex analysis, respectively. Intragroup comparison was performed by Friedman and Dunn's multiple comparison tests, whereas the Mann-Whitney U-test was applied for intergroup analyses.

Results: Cessation of oral hygiene resulted in a significant increase in VPI, GBI and gingival crevicular fluid volume in both groups, which returned to baseline levels 7 d after oral hygiene was resumed. Smokers presented lower GBI than did nonsmokers (p < 0.05) at day 21. Smokers had higher total bacterial counts and higher proportions of red- and orange complex bacteria, as well as lower proportions of Actinomyces spp., and of purple- and yellow-complex bacteria (p < 0.05). Furthermore, the levels of key immune-regulatory cytokines, including interleukin (IL)-8, IL-17 and interferon-γ, were higher in smokers than in nonsmokers (p < 0.05).

Conclusion: Smokers and nonsmokers developed gingival inflammation after supragingival biofilm accumulation, but smokers had less bleeding, higher proportions of periodontal pathogens and distinct host-response patterns during the course of experimental gingivitis.

Keywords: experimental gingivitis; gingivitis; risk factors; smoking.

MeSH terms

  • Biofilms / growth & development
  • Case-Control Studies
  • Cytokines / analysis
  • Dental Plaque Index
  • Female
  • Gingival Crevicular Fluid / chemistry
  • Gingivitis / etiology*
  • Gingivitis / immunology
  • Gingivitis / microbiology
  • Humans
  • Male
  • Periodontal Index
  • Prospective Studies
  • Smoking / adverse effects*
  • Young Adult

Substances

  • Cytokines