Systemic 2022 (smoking/BMI/Gender...)

Question 1

What broad ways does smoking impact perio experience? Citations for each

Answer 1

Microbiological (Zambon 1996)
Immunilogical (Macfarlane 1992)
Physical (Palmer 2005)

Question 2

What is the microbiological impact of smoking in perio?

Answer 2

Zambon 1992 found a change in the quality of bacteria with more colonization of T Forsythia

Question 3

What is the immunilogical impact of smoking on perio?

Answer 3

Macfarlane 1992 described impared phagocytosis and neutrophil recruitment

Question 4

What is the physical impact of smoking on perio?

Answer 4

Reduced blood vessel density (Palmer 2005) leading to lower tissue perfusion and impared healing

Question 5

How does smoking effect the success of treatment?

Answer 5

Tonetti et al. 1995
2.1mm CAL vs 5.2mm CAL

Question 6

How does diabetes impact perio?

Answer 6

Advanced glycation end products (AGEs) which are formed in hyperglycemia, result in
increased thickness in the microvasculature, this will alter normal homeostatic
transport.
Also act on RAGE to increase IL1b and increase osteoclastogenesis

Question 7

How is the micrbiome of perio effected by diabetes?

Answer 7

Xaio et al. 2017
Increased IL17 expression and other inflammatory mediators leads to increased pathogenicity in perio

Question 8

Are diabetics at an increased risk of perio?

Answer 8

Tsai et al. 2002
A1c >9% had OR of 2.9 for severe perio
Emrich 1991
OR 2.8 when CAL was used to diagnose

Question 9

Does alcohol increase the risk for perio?

Answer 9

Tezel 2004
5+drinks/week: OR 1.36
10+drinks/week: OR 1.44

Question 10

What gender is at greater risk for perio?

Answer 10

males had a higher incidence of moderate-severe
periodontal disease with an OR of 2.2 compared to females (Montero, 2019)

Question 11

What genetic disorders are linked to perio?

Answer 11

Downs Syndrome
Leukocyte Adhesion Deficiency
Papillon Lefevre
IL1 Genotype Polymorphism

Question 12

How does smoking impact SRP outcomes?

Answer 12

Grossi et al. 1996

SSD PD reduction
Smokers: 1.29mm
Non-smokers: 1.76

Question 13

How does smoking impact OFD (no numbers)

Answer 13

Past smokers + non smokers > PD reduction / CAL gain vs heavy /smokers and light smokers
Khaldal 1996

Question 14

How does smoking impact OFD (numbers)

Answer 14

Preber et al. 1990

SSD PD Reduction
Smokers: 0.76mm
Non-smokers: 1.27mm

Question 15

How does smoking impact regeneration outcomes?

Answer 15

Tonetti et al. 1995

CAL gain:
Smokers: 2.1mm
Non-smokers: 5.2mm

Question 16

How much more likely is it for a smoker to have perio vs a non-smoker?

Answer 16

Tomar & Asma 2000

Smokers have and OR of 3.97