Introduction: The destructive periodontal disease is the result of a complex interaction between the subgingival microflora and nonbacterial factors, specifically host and environmental factors. Principal susceptibility factors are genetic conditions of the immunoinflammatory response but tobacco dependence might be the proper risk factor in periodontitis. The aim of the work was to qualify the influence of cotinine and 3'hydroxycotinine as the main metabolites of nicotine, on the course and degree of chronic periodontitis advancement, according to clinical parameters of the periodontium condition among generally healthy heavy smoking adults.
Material and methods: The study covered two groups of adult patients with periodontitis. One group with tobacco dependence and one group of never smoking patients. The first group comprised of 38 women who were smoking for 5 years without quitting (minimum 10 cigarettes per day). The second group was made up of 47 men who never smoked. The patients from the second group formed the control group being relative to the heavy smoking patients with chronic periodontitis. In the examined groups there were 43 women from amongst which 18 were smokers and 25 who have never smoked. Among the 42 males that were in the examined groups 20 of them were heavy smokers and 22 nonsmokers. All the participants were qualified to groups based on information from an interview, clinical examination, an analysis of x-ray images and a questionnaire defining their addiction to tobacco smoking. Clinical measurements and biological material were taken by the author of the work in homogeneous conditions of a dental surgery. The following clinical parameters were evaluated: approximal plaque index (API), sulcus bleeding index (SBI), depth of periodontal pockets (PD), clinical attachment level (CAL), recession depth and width recession of periodontal tissues, number of furcated teeth and the furcation class, number and degree of teeth mobility, number of retained teeth as well as the number of teeth lost resulting from periodontitis. After obtaining consent from the Bioethical Committee of Pomeranian Medical University in Szczecin the biological material consisted of blood serum withdrawn from each patient that was qualified to the examined group.
Results and conclusions: Received results of studies were subjected to statistical analysis by using a computer software Statistica P1 version 7.1. Investigations have shown characteristic both clinical and statistical differences including a correlation between the measured average value indicators among the smokers as well as non-smokers with chronic periodontitis. The research revealed a positive correlation in the number of retained teeth with the number of lost teeth and smoking. In the group of smokers the percent of retained teeth was greatly lower, however, the percent of lost teeth much higher in comparison to the group of nonsmokers. The level of hygiene was comparable in both groups, but the lesions were more intense in smokers. Hence, taking into account the level of hygiene, the habit of smoking had an independent effect on the advancement degree of periodontitis. Among the smokers a significant fewer percent was noticed of bleeding sites during the probing of the depth of pockets despite a comparable hygiene level. The advancement of destructive lesions of periodontal tissues remains in correlation with the habit of smoking tobacco. The studies confirm a greater destruction of the alveolar bone, bigger probing attachment loss and a higher percent of teeth indicating mobility as well as furcation among heavy smokers.