ISSN : 0376-4672
흡연은 인체에 다양한 전신 질환을 유발하는 위험인자(risk factor)로서, 폐암의 90%, 만성 폐질환의 70%, 심근경색 질환의 80%, 허혈성 심질환의 30% 가 흡연에 의해 유발된다고 추정되고 있다. 이 외에도 많은 전신 질환이 흡연과 깊은 관계를 보여, 골다공증 환자의 경우에는 장기간 흡연 시 골다공증 증상이 악화될 수 있으며, 폐경기에 접어든 여성의 경우에는 흡연 시 고관절 골절 빈도가 높게 나타나고 금연 시에는 그 위험율이 현저히 감소하는 것으로 밝혀졌다.
Cigarette smoking is a significant risk factor for periodontaldiseases and implant treatments. Smoking control is regarded as a key to the success of dental treatments as well as the well-being of the patients. The aim of this study was to reviewthe effects of smoking on periodontal health, and the results of periodontal therapy and implant treatments. Also, in vitro, microbiological, immunological and epidemiological relationships were studied. In vitro studies show that smoking interferes with normal healing process and increased tissue destruction. There is still controversy on the population of microbes of smokers. Smokers showed significantly less gingival inflammation and bleeding on probing compared with non-smokers. After periodontal treatments, a compromised clinical outcome was noted for smokers in terms of pocket depth reduction and gain in attachment levels. In conclusion, data from in vitro, epidemiological, cross-sectional and case?control studiesstrongly suggest that quitting smoking is beneficial to patients before periodontal and implant treatments.
1. Fielding JE. Smoking: health effects and control (1). N Engl J Med 1985;313(8):491-498.
2. La Vecchia C, Boyle P, Franceschi S, et al. Smoking and cancer with emphasis on Europe. Eur J Cancer 1991;27(1):94-104.
3. Peto R, Lopez AD, Boreham J, et al. Mortality from smoking worldwide. Br Med Bull 1996;52(1):12-21.
4. Hagiwara S, Tsumura K. Smoking as a risk factor for bone mineral density in the heel of Japanese men. J Clin Densitom 1999;2(3):219-222.
5. Baron JA, Farahmand BY, Weiderpass E, et al. Cigarette smoking, alcohol consumption, and risk of hip fracture in women. Arch Intern Med 2001;161(7):983-988.
6. Kikendall JW, Evaul J, Johnson LF. Effect of cigarette smoking on gastrointestinal physiology and non-neoplastic digestive disease. J Clin Gastroenterol 1984;6(1):65-79.
7. Riefkohl R, Wolfe JA, Cox EB, McCarty KS, Jr. Association between cutaneous occlusive vascular disease, cigarette smoking, and skin slough after rhytidectomy. Plast Reconstr Surg 1986;77(4):592-595.
8. Herring M, Gardner A, Glover J. Seeding human arterial prostheses with mechanically derived endothelium. The detrimental effect of smoking. J Vasc Surg 1984;1(2):279-289.
9. Skurnik Y, Shoenfeld Y. Health effects of cigarette smoking. Clin Dermatol 1998;16(5):545-556.
10. Johnson GK, Slach NA. Impact of tobacco use on periodontal status. J Dent Educ 2001;65(4):313-321.
11. Scabbia A, Cho KS, Sigurdsson TJ, et al. Cigarette smoking negatively affects healing response following flap debridement surgery. J Periodontol 2001;72(1):43-49.
12. Sham AS, Cheung LK, Jin LJ, Corbet EF. The effects of tobacco use on oral health. Hong Kong Med J 2003;9(4):271-277.
13. Preber H, Bergstrom J. Occurrence of gingival bleeding in smoker and non-smoker patients. Acta Odontol Scand 1985;43(5):315-320.
14. Bain CA, Moy PK. The association between the failure of dental implants and cigarette smoking. Int J Oral Maxillofac Implants 1993;8(6):609-615.
15. De Bruyn H, Collaert B. The effect of smoking on early implant failure. Clin Oral Implants Res 1994;5(4):260-264.
16. Wallace RH. The relationship between cigarette smoking and dental implant failure. Eur J Prosthodont Restor Dent 2000;8(3):103-106.
17. Keller EE, Tolman DE, Eckert SE. Maxillary antralnasal inlay autogenous bone graft reconstruction of compromised maxilla: a 12-year retrospective study. Int J Oral Maxillofac Implants 1999;14(5):707-721.
18. Geurs NC, Wang IC, Shulman LB, Jeffcoat MK. Retrospective radiographic analysis of sinus graft and implant placement procedures from the Academy of Osseointegration Consensus Conference on Sinus Grafts. Int J Periodontics Restorative Dent 2001;21(5):517-523.
19. 보건복지부. 2011년도 상반기 성인 흡연 실태조사 결과-대한민국 성인남성 흡연율, 지속 하락. 서울: 보건복지부, 2011년 7월 21일.
20. Hoffmann D, Hoffmann I. The changing cigarette, 1950-1995. J Toxicol Environ Health 1997;50(4):307-364.
21. Silverstein P. Smoking and wound healing. Am J Med 1992;93(1A):22S-24S.
22. Ryder MI, Fujitaki R, Lebus S, et al. Alterations of neutrophil L-selectin and CD18 expression by tobacco smoke: implications for periodontal diseases. J Periodontal Res 1998;33(6):359-368.
23. Tanur E, McQuade MJ, McPherson JC, et al. Effects of nicotine on the strength of attachment of gingival fibroblasts to glass and non-diseased human root surfaces. J Periodontol 2000;71(5):717-722.
24. James JA, Sayers NM, Drucker DB, Hull PS. Effects of tobacco products on the attachment and growth of periodontal ligament fibroblasts. J Periodontol 1999;70(5):518-525.
25. 김일영, 박미영, 최성호, et al. 흡연자와 비흡연자의 치은섬유아세포에서 니코틴과 NNK가 부착과 성장에 미치는 영향. 대한치주과학회지 1998;28(4):677-692.
26. Snyder HB, Caughman G, Lewis J, et al. Nicotine modulation of in vitro human gingival fibroblast beta1 integrin expression. J Periodontol 2002;73(5):505-510.
27. Tipton DA, Dabbous MK. Effects of nicotine on proliferation and extracellular matrix production of human gingival fibroblasts in vitro. J Periodontol 1995;66(12):1056-1064.
28. Theiss SM, Boden SD, Hair G, et al. The effect of nicotine on gene expression during spine fusion. Spine (Phila Pa 1976) 2000;25(20):2588-2594.
29. Pinto JR, Bosco AF, Okamoto T, et al. Effects of nicotine on the healing of extraction sockets in rats. A histological study. Braz Dent J 2002;13(1):3-9.
30. Henemyre CL, Scales DK, Hokett SD, et al. Nicotine stimulates osteoclast resorption in a porcine marrow cell model. J Periodontol 2003;74(10):1440-1446.
31. Kaldahl WB, Johnson GK, Patil KD, Kalkwarf KL. Levels of cigarette consumption and response to periodontal therapy. J Periodontol 1996;67(7):675-681.
32. Johnson GK, Guthmiller JM. The impact of cigarette smoking on periodontal disease and treatment. Periodontol 2000 2007;44:178-194.
33. Darby IB, Hodge PJ, Riggio MP, Kinane DF. Microbial comparison of smoker and non-smoker adult and early-onset periodontitis patients by polymerase chain reaction. J Clin Periodontol 2000;27(6):417-424.
34. Preber H, Bergstrom J, Linder LE. Occurrence of periopathogens in smoker and non-smoker patients. J Clin Periodontol 1992;19(9 Pt 1):667-671.
35. Zambon JJ, Grossi SG, Machtei EE, et al. Cigarette smoking increases the risk for subgingival infection with periodontal pathogens. J Periodontol 1996;67(10 Suppl):1050-1054.
36. Umeda M, Chen C, Bakker I, et al. Risk indicators for harboring periodontal pathogens. J Periodontol 1998;69(10):1111-1118.
37. Haffajee AD, Socransky SS. Relationship of cigarette smoking to the subgingival microbiota. J Clin Periodontol 2001;28(5):377-388.
38. Eggert FM, McLeod MH, Flowerdew G. Effects of smoking and treatment status on periodontal bacteria: evidence that smoking influences control of periodontal bacteria at the mucosal surface of the gingival crevice. J Periodontol 2001;72(9):1210-1220.
39. Giannopoulou C, Geinoz A, Cimasoni G. Effects of nicotine on periodontal ligament fibroblasts in vitro. J Clin Periodontol 1999;26(1):49-55.
40. Graswinckel JE, van der Velden U, van Winkelhoff AJ, et al. Plasma antibody levels in periodontitis patients and controls. J Clin Periodontol 2004;31(7):562-568.
41. Smith MR, Kinmonth AL, Luben RN, et al. Smoking status and differential white cell count in men and women in the EPIC-Norfolk population. Atherosclerosis 2003;169(2):331-337.
42. Apatzidou DA, Riggio MP, Kinane DF. Impact of smoking on the clinical, microbiological and immunological parameters of adult patients with periodontitis. J Clin Periodontol 2005;32(9):973-983.
43. Gunsolley JC, Tew JG, Gooss C, et al. Serum antibodies to periodontal bacteria. J Periodontol 1990;61(7):412-419.
44. Barbour SE, Nakashima K, Zhang JB, et al. Tobacco and smoking: environmental factors that modify the host response (immune system) and have an impact on periodontal health. Crit Rev Oral Biol Med 1997;8(4):437-460.
45. Kinane DF, Chestnutt IG. Smoking and periodontal disease. Crit Rev Oral Biol Med 2000;11(3):356-365.
46. Mirbod SM, Ahing SI, Pruthi VK. Immunohistochemical study of vestibular gingival blood vessel density and internal circumference in smokers and non-smokers. J Periodontol 2001;72(10):1318-1323.
47. Morozumi T, Kubota T, Sato T, et al. Smoking cessation increases gingival blood flow and gingival crevicular fluid. J Clin Periodontol 2004;31(4):267-272.
48. Nair P, Sutherland G, Palmer RM, et al. Gingival bleeding on probing increases after quitting smoking. J Clin Periodontol 2003;30(5):435-437.
49. Martinez-Canut P, Lorca A, Magan R. Smoking and periodontal disease severity. J Clin Periodontol 1995;22(10):743-749.
50. Tomar SL, Asma S. Smoking-attributable periodontitis in the United States: findings from NHANES III. National Health and Nutrition Examination Survey. J Periodontol 2000;71(5):743-751.
51. Heasman L, Stacey F, Preshaw PM, et al. The effect of smoking on periodontal treatment response: a review of clinical evidence. J Clin Periodontol 2006;33(4):241-253.
52. Labriola A, Needleman I, Moles DR. Systematic review of the effect of smoking on nonsurgical periodontal therapy. Periodontol 2000 2005;37:124-137.
53. Kinane DF, Radvar M. The effect of smoking on mechanical and antimicrobial periodontal therapy. J Periodontol 1997;68(5):467-472.
54. Renvert S, Dahlen G, Wikstrom M. The clinical and microbiological effects of non-surgical periodontal therapy in smokers and non-smokers. J Clin Periodontol 1998;25(2):153-157.
55. Preber H, Bergstrom J. Effect of cigarette smoking on periodontal healing following surgical therapy. J Clin Periodontol 1990;17(5):324-328.
56. Bostrom L, Linder LE, Bergstrom J. Influence of smoking on the outcome of periodontal surgery. A 5-year follow-up. J Clin Periodontol 1998;25(3):194-201.
57. Haffajee AD, Cugini MA, Dibart S, et al. The effect of SRP on the clinical and microbiological parameters of periodontal diseases. J Clin Periodontol 1997;24(5):324-334.
58. Borrell LN, Papapanou PN. Analytical epidemiology of periodontitis. J Clin Periodontol 2005;32 Suppl 6:132-158.
59. Reibel J. Tobacco and oral diseases. Update on the evidence, with recommendations. Med Princ Pract 2003;12 Suppl 1:22-32.
60. Jones JK, Triplett RG. The relationship of cigarette smoking to impaired intraoral wound healing: a review of evidence and implications for patient care. J Oral Maxillofac Surg 1992;50(3):237-239; discussion 239-240.
61. Haas R, Haimbock W, Mailath G, Watzek G. The relationship of smoking on peri-implant tissue: a retrospective study. J Prosthet Dent 1996;76(6):592-596.
62. Hultin M, Fischer J, Gustafsson A, et al. Factors affecting late fixture loss and marginal bone loss around teeth and dental implants. Clin Implant Dent Relat Res 2000;2(4):203-208.
63. Bain CA. Implant installation in the smoking patient. Periodontol 2000 2003;33:185-193.
64. Kan JY, Rungcharassaeng K, Lozada JL, Goodacre CJ. Effects of smoking on implant success in grafted maxillary sinuses. J Prosthet Dent 1999;82(3):307-311.
65. Miller PD, Jr. Root coverage using the free soft tissue autograft following citric acid application. III. A successful and predictable procedure in areas of deep-wide recession. Int J Periodontics Restorative Dent 1985;5(2):14-37.
66. Bain CA. Long-term smoking cessation in dental implant patients. 16th Scientifc Meeting, Academy of Osseointegration. Toronto, 2001.
