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      The Effect of Smoking Habit on Apical Status of Adequate Endodontically Treated Teeth with and Without Periodontal Involvement

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          Abstract

          Background

          The possible connection between apical periodontitis (AP), periodontal disease (PD) and the bad habit of smoking is among the most interesting aspects faced by the dental scientific community. The aim of this study was to pinpoint the effect of smoking on the status of the apical region, in properly root-filled teeth with and without periodontal involvement of Iraqi males.

          Materials and methods

          Total number of 75 patients were chosen, divided into 3 groups of 25’s, teeth were subdivided into 6 subgroups (G-a: Light smokers without Periodontal involvement, G-b: Heavy smokers without Periodontal involvement, G-c: Non-smokers without Periodontal involvement, G-d: Light smokers with Periodontal involvement, G-e: Heavy smokers with Periodontal involvement, G-f: Non-smokers with Periodontal involvement), examination involved: clinical periodontal parameters, coronal restoration fitness. Panoramic and periapical radiographs were used to judge the quality of periodontal tissue in the apical region (AP) of root canal treated teeth.

          Results

          Among all the examined teeth (1859), only (89) were found with fitted both coronal and endodontic restorations. Rates of AP were: (G-a: 11.1%, G-b: 25%, G-c: 0%, G-d: 18.8%, G-e: 35.7%, G-f: 4.8%). Statistically, in related to the AP, there was a highly significant difference between heavy smokers’ groups (G-b, G-e). Moreover, heavy smokers with PD (G-e) showed a significant difference with light smokers without PD (G-a) and non-smokers without PD (G-c), also, there was a significant difference between heavy smokers without PD (G-b) and non-smokers with PD (G-f). While, there was a non-significant difference relationship between non–smokers’ groups (G-c, G-f), and light smokers’ groups (G-a, G-d).

          Conclusion

          There is a noticeable negative effect of smoking on the severity and prognosis of AP and this negative effect worsens when it is accompanied by lateral periodontitis.

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          Most cited references42

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          Periodontal treatment of multirooted teeth. Results after 5 years.

          Sven-Erik Hamp, Sture Nyman, Jan Lindhe (1975)
          This paper describes: (1) a system for classification and treatment of furcation involvements, and (2) a 5-year post-operative evaluation of 100 patients treated for periodontal breakdown in the bi/tri-function areas. The results of this study demonstrate that it is possible to arrest further destruction within the root furcation area. The successful treatment of the multirooted teeth was probably the consequence of: (1) the quasi total elimination of plaque retention areas from the bi/tri-furcation area, and (2) meticulous oral hygiene by the patients.
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            Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration.

            Richard H. Ray, M Trope (1994)
            The purpose of this study was to evaluate the relationship of the quality of the coronal restoration and of the root canal obturation on the radiographic periapical status of endodontically treated teeth. Full-mouth radiographs from randomly selected new patient folders at Temple University Dental School were examined. The first 1010 endodontically treated teeth restored with a permanent restoration were evaluated independently by two examiners. Post and core type restorations were excluded. According to a predetermined radiographic standard set of criteria, the technical quality of the root filling of each tooth was scored as either good (GE) or poor (PE), and the quality of the coronal restoration similarly good (GR) or poor (PR). The apical one-third of the root and surrounding structures were then evaluated radiographically and the periradicular status categorized as (a) absence of periradicular inflammation (API) or (b) presence of periradicular inflammation (PPI). The rate of API for all endodontically treated teeth was 61.07%. GR resulted in significantly more API cases than GE, 80% versus 75.7%. PR resulted in significantly more PPI cases than PE, 30.2% versus 48.6%. The combination of GR and GE had the highest API rate of 91.4%, significantly higher than PR and PE with a API rate of 18.1%.
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              Evidence for cigarette smoking as a major risk factor for periodontitis.

              Tamsyn M Crowley, Jillian Kent, Jordana J. Haber … (1992)
              The role of smoking as a risk factor for periodontitis was assessed separately in diabetic and nondiabetic study groups. Subject listings stratified for age (19 to 40 years) and sex were obtained for subjects with insulin-dependent diabetes mellitus (IDDM) and nondiabetic subjects. For both the IDDM group (n = 132) and the nondiabetic group (n = 95), age and sex stratified samples were constructed by random selection of subjects from each subject listing. Patients were recruited by phone, examined, and their medical and dental histories obtained. Among nondiabetic subjects, the prevalence of periodontitis was markedly higher among current smokers compared with never smokers (P or = 4 mm was higher among current smokers than never smokers (P = 0.001) in the 19 to 30 (8.2% vs. 3.4%) and 31 to 40 (14.3% vs. 4.3%) age groups. The effects of smoking among IDDM subjects were similar to that observed in the nondiabetic population. There were no differences between current and never smokers in the proportion of sites positive for plaque. Attributable risk percents from prevalence data suggest that among nondiabetic subjects, a large proportion, perhaps as much as 51% of the periodontitis in the 19 to 30 year old group and 32% of the periodontitis in the 31 to 40 year old group, is associated with smoking.(ABSTRACT TRUNCATED AT 250 WORDS)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Cosmet Investig Dent
                Journal ID (iso-abbrev): Clin Cosmet Investig Dent
                Journal ID (publisher-id): CCIDE
                Journal ID (pmc): ccident
                Title: Clinical, Cosmetic and Investigational Dentistry
                Publisher: Dove
                ISSN (Electronic): 1179-1357
                Publication date (Electronic): 30 December 2019
                Publication date Collection: 2019
                Volume: 11
                Pages: 419-428
                Affiliations
                [1 ]Department of Periodontology, College of Dentistry, Mustansiriyah University , Baghdad, Iraq
                [2 ]Department of Periodontology, College of Dentistry, Uruk University , Baghdad, Iraq
                [3 ]Department of Dentistry, Al-Rafidain University-College , Baghdad, Iraq
                Author notes
                Correspondence: Hashim M Hussein Department of Dentistry, Al-Rafidain University-College , Palestine Street, P.O., Box 46036, Baghdad, IraqTel +964 780 710 1071 Email hashimmueenhussein@gmail.com
                Author information
                http://orcid.org/0000-0003-3095-7092
                http://orcid.org/0000-0003-0484-9370
                http://orcid.org/0000-0002-1981-2768
                Article
                Publisher ID: 236747
                DOI: 10.2147/CCIDE.S236747
                PMC ID: 6941597
                PubMed ID: 31920402
                SO-VID: b10a360c-9720-4932-9366-555cfe5104b3
                Copyright © © 2019 Mahmood et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 31 October 2019
                Date accepted : 03 December 2019
                Page count
                Tables: 5, References: 45, Pages: 10
                Categories
                Subject: Original Research

                Keywords: smoking,apical periodontitis,root canal therapy,periapical index
                Data availability:
                Keywords: smoking, apical periodontitis, root canal therapy, periapical index

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