Impaired treatment outcome following GTR in gingival recession defects in cigarette smokers

This retrospective study evaluated healing response in gingival recession defects following GTR in smokers. Twenty-two systemically healthy patients who had been treated for deep ( ³ 4 mm), buccal, Miller’s Class I or II gingival recession defects with e-PTFE membranes were included. Patients were regarded as smokers if they smoked more than 10 cigarettes/day at the time of surgical procedure. Occasional and former smokers were excluded. Nine patients (6 males, mean age: 29 years) were smokers, while 13 patients (4 males, mean age: 35 years) were non-smokers. Clinical parameters, recorded presurgery and at 6 months postsurgery, included defect-specific plaque (DPl) and bleeding on probing (BoP) scores, recession depth (RD), probing depth (PD), clinical attachment level (PAL), and keratinized tissue width (KT). Extent of membrane exposure (ME) and newly formed tissue (NFT) gain were assessed at membrane removal. Statistical analysis revealed no significant differences between smokers and non-smokers in demographic and presurgery defect characteristics. DPl and BoP scores were similar presurgery and remained almost unchanged thoroughout the observation interval in both groups. ME was significantly greater in smokers (2.6 ± 1.4 mm) than in non-smokers (1.3 ± 0.6 mm). NFT gain was 2.8 ± 1.0 mm in smokers and 3.6 ± 1.4 mm in non-smokers, the difference being not statistically significant. Smokers showed significantly less RD reduction and root coverage (2.5 ± 1.2 mm and 57%, respectively) compared to non-smokers (3.6 ± 1.1 mm and 78%, respectively). In conclusion, the results indicate that treatment outcome following GTR in gingival recession defects is impaired in cigarette smokers. This study was partly supported by MURST grant #95/60/06/14