Influence of smoking on clinical parameters and gingival crevicular fluid volume in patients with chronic periodontitis.

BACKGROUND Tobacco smoking is regarded as one of the most significant risk factors for the development and progression of periodontal disease. In particular, studies have shown an alteration in Gingival Crevicular Fluid (GCF) volume and its components in smokers. OBJECTIVE The purpose of this study was to compare the GCF volume in smoking and non-smoking Saudi subjects with chronic periodontitis. METHODS In this study, 30 smoking patients and 30 non-smoking patients with chronic periodontitis were enrolled. Periodontal Probing Depth (PPD), Clinical Attachment Level (CAL), Plaque Index (PI), and Bleeding on Probing (BOP) were measured to assess the pattern of periodontal destruction for each patient at six sites in selected teeth. Gingival inflammation was registered at six sites, where Gingival Crevicular Fluid (GCF) was also collected. The GCF volume was measured with a Periotron 8000®. Comparisons were made between smoking and non-smoking groups with periodontitis. RESULTS Smokers demonstrated significantly deeper periodontal pockets (4.64±0.30 mm) than non-smokers (4.24±0.38 mm). Smoking subjects also presented significantly greater attachment loss (3.08±0.28 mm) than non-smoking subjects (2.74±0.42 mm), whereas the GCF volume was found to be significantly lower in smokers (0.25±0.04 μl) than in non-smokers (0.31±0.05 μl) (P<0.01). Among smoking subjects, lingual sites showed reduced GCF levels compared to facial sites (0.22±0.03 μl vs. 0.25±0.03 μl). CONCLUSION Smoking appears to have considerable adverse effects on the inflammatory process, thereby promoting the progression of periodontal disease in smokers. CLINICAL SIGNIFICANCE The adverse effect of smoking on the initiation and progression of periodontal disease is highlighted in this study. In particular, estimation of the GCF volume may serve as an indicator to assess the severity as well as the prognosis of periodontitis in smokers.