Aim:
Smoking is the strongest modifiable risk factor for periodontal diseases that also deteriorates the response to periodontal treatment. Mucogingival operations may also provide less successful outcomes in smokers. The aim of this study was to evaluate possible effects of smoking on long-term stability of root coverage using coronally advanced flap procedures in localized gingival recessions.

Methods:
Six recession defects in each of the smoker and non-smoker groups were evaluated in this study. Coronally advanced flap was performed with microsurgery technique. Probing depth, clinical attachment level, keratinized gingival width, plaque index, papilla bleeding index, recession depth, recession width, and root surface area were evaluated at baseline, and then postoperative 6-month, and 6-year follow-up sessions. Percentage of root coverage and complete root coverage were also calculated at postoperative controls. Data were analysed with appropriate statistical tests.

Results:
All patients included in this study provided efficient plaque control and good oral hygiene level was maintained throughout the study protocol. Baseline clinical attachment level measurements revealed significantly higher values in the smoker group (p<0.05). All other clinical measurements were similar in the smoker and non-smoker groups at baseline and also at 6-month and 6-year control evaluations (p>0.05).

Conclusions:
This 6-year follow-up study suggests that smoking does not have a significant adverse effect on the long-term stability of root coverage as long as the patients maintained efficient plaque control.

Funding:
This study was supported by a grant from the Ege University Research Foundation (Project No: 2010 DIS 004).