Journal of International Dental and Medical Research ISSN 1309-100X Periodontal Regeneration of Bony defects in Smokers http://www.ektodermaldisplazi.com/journal.htm Hossam A. Eid and Basma M. Zaki Volume ∙ 9 ∙ Number ∙ 1 ∙ 2016 Page 55 EFFECT OF PLATELET-RICH PLASMA IN COMBINATION WITH BONE ALLOGRAFT IN TREATMENT OF PERIODONTAL INTRA-BONY DEFECTS IN SMOKERS Hossam A. Eid 1 , Basma M. Zaki 2 * 1. Assistant Professor, Oral Medicine and Periodontology Department , Faculty of Dentistry, Suez Canal University, Ismailia, Egypt, Department of Periodontics, College of Dentistry, Gulf Medical University, Ajman, UAE. 2. Assistant Professor, Surgery and Oral Medicine Department, Oral and Dental Research Division, National Research Centre, Egypt. Abstract This study was conducted to evaluate the influence of smoking habit on the success of periodontal regeneration in treating intra-bony periodontal defects when using Platelet Rich Plasma (PRP) combined with Freeze Dried Bone Allograft (FDBA). Thirty patients all diagnosed as having advanced chronic periodontitis were selected. The patients were equally allocated into two equal groups: Group I; (n=15) which included non-smoking patients having periodontal intra-bony defects managed with PRP and FDBA and Group II; (n=15) included smoking patients having periodontal intra-bony defects managed with PRP and FDBA. Clinical evaluation recording the plaque index (PI), gingival index (GI), pocket depth (PD), and clinical attachment level (CAL) was done. Radiographic assessment was also carried out to calculate the amount of bone gain. Estimation of the level of Platelet Derived Growth Factor (PDGF-BB) was performed. The results revealed that the clinical improvement, the amount of bone gain and the level of PDGF-BB were more in the non-smokers group. Smoking has a negative impact on the treatment outcomes of the periodontal intra-bony defects following the combined treatment of PRP and FDBA. Clinical article (J Int Dent Med Res 2016; 9: (1), pp. 55-63) Keywords: Smoking, intra-bony periodontal defects, PRP, FDBA. Received date: 19 February 2016 Accept date: 07 March 2016 Introduction The purpose of periodontal therapy is to arrest the destruction accompanied with the periodontal disease progression and to regenerate the lost structures achieving optimal comfort, function and esthetic appearance 1 . The etiology of the chronic inflammatory periodontal disease process is multifactorial in nature. It results from the interaction between the microbial infection and the host defense finally leading to clinical attachment loss and alveolar bone resorption 2-4 . Various studies conducted on animals and humans proved that smoking can damage the vascular and immunological systems tipping the balance favoring the tissue breakdown 5 . It decreases the self-healing capacity of the tissues of the periodontium. It was documented that, the outcome of periodontal treatment in smokers is less favorable as the host cytokine levels in bio- fluids is affected in smokers 6 . In comparison to non smokers, periodontal pathogenic bacteria conquer higher levels in smokers' patients. This is caused by the direct modulation of the sub-gingival microflora favoring the colonization of these pathogenic bacteria 7 . In addition, there is increased evidence that smoking may interrupt the normal healing events of the periodontal tissues 8 . Clinical studies showed that after adjusting the plaque accumulation to be similar in both smokers and non-smokers the individuals *Corresponding author: Dr. Basma Mostafa Zaki Oral and Dental Research Division, National Research Centre, 33 El Bohouth Street, 12622 Dokki, Cairo, Egypt. Phone: +201224901019 E-mail: boshta@hotmail.com