The Impact Of Smoking On C-reactive Protein Levels In The Gingival Crevicular Fluid Before And After Initial Treatment In Periodontitis

Periodontitis is a chronic infection in periodontal support tissue caused by avariety of risk factors, chiefly when plaque micro-organisms settle in the cervical andgingival sulcus. Although plaque is a periodontal disease initiating factor, the presenceof plaque does not necessarily cause periodontal disease. Smoking is an major causeof many human diseases, and several lateral and longitudinal studies have confirmedthat smoking is a risk factors for periodontitis, in particular for severe periodontitis.Gingival crevicular fluid contains a variety of ingredients derived from bacteria andhuman tissue. The amount of gingival crevicular fluid and the changes in itscomposition can be used as indicators to judge periodontitis clinical symptoms andprognosis. CRP, as an acute phase response proteins, plays a key role in theproinflammatory process. Therefore, CRP is drawing more and more scholars’attention in recent years.Objective:1. Explore the impact of smoking on periodontal tissue destruction, by comparing ofthe PLI, BI, PD, AL of smoking and non-smoking periodontitis patients beforeinitial treatment.2. Explore the impact of smoking on GCF volume and CRP concentration in GCF inthe periodontal disease status, by detecting the GCF volume and CRP levels inGCF before initial treatment.3. Explore the effect of periodontal initial treatment on smoking and non-smokingperiodontitis patients, and the effect of smoking on periodontal initial treatment,by comparing of the PLI, BI, PD, AL, GCF volume and CRP concentration inGCF of smoking and non-smoking periodontitis patients before and after initialtreatment.Methods:1. Choice of cases: Randomly selected age, sex matched smokers and non-smokers18cases, treated in Stomatology Hospital of Jilin University in March2011toOctober2011and diagnosed with severe periodontitis.2. Sample collection and preservation: obtain gingival crevicular fluid by using absorbent paper point, and weigh with an electronic balance. Store the gingivalcrevicular fluid in a-70°C temperature refrigerator.3. Inspect and record the clinical indicators: determine the amount of subjectsplaque accumulation by using Silness&L e plaque index; observe the degree ofbleeding gums by using Mazza sulcus bleeding index scoring method; At thesame time, detect subjects PD, AL in accordance with the standard ofPeriodontology (3rd edition)..4. Detect CRP concentration in GCF: radioimmunoassay balance method will beused to determine CRP levels in the samples.5. Statistical analysis: All data obtained from the experiment were analyzed by theStatistical Package SPSS13.0.Results:1. Before the initial periodontal therapy, the PLI, PD and AL of the smoking groupwere significantly higher than non-smoking group, while the smoking group’s BIwas lower than non-smoking group. After initial periodontal therapy over4weeks,the PLI, BI, PD, AL of the smoking and non-smoking groups were significantlyreduced compared with pre-treatment.2. Before the initial periodontal therapy, GCF volume and CRP concentration inGCF of the smoking group was significantly higher than the non-smoking group.After initial periodontal therapy4weeks, GCF volume and CRP concentration inGCF of the smoking group and non-smoking group were significantly lower thanbefore treatment.3. Before and after the initial treatment, there were significantly differences in thechanges of PLI, BI, PD, AL, GCF volume and CRP concentration in GCF of thesmoking and non-smoking periodontitis patients. The PLI change of the smokinggroup was more significant than that of the non-smoking group, but the changesof other clinical indicators were less significant than those for the non-smokinggroup.Conclusion:1. The amount of plaque accumulation in smokers is greater than non-smokers andthe smokers’ periodontal tissue destruction was more serious than non-smokers.2. The degree of periodontal disease of smokers are more serious than non-smokers,and that is related with CRP concentration in GCF. 3. The initial periodontal therapy could significantly improve the inflammatorycondition for both smokers and non-smokers, and smoking may be unfavorablefactors of the initial periodontal therapy in periodontitis.