Smoking and dental implants: A systematic review and meta-analysis

ObjectiveRecent studies implicate smoking as a significant factor in the failure of dental implants. This review aims to test the null hypothesis of no difference in the implant failure rates, risk of postoperative infection, and marginal bone loss for smokers versus non-smokers, against the alternative hypothesis of a difference.DataMain search terms used in combination: dental implant, oral implant, smoking, tobacco, nicotine, smoker, and non-smoker.SourcesAn electronic search was undertaken in September/2014 in PubMed/Medline, Web of Science, Cochrane Oral Health Group Trials Register plus hand-searching.Study selectionEligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 1432 publications, of which 107 were eligible, with 19,836 implants placed in smokers, with 1259 failures (6.35%), and 60,464 implants placed in non-smokers, with 1923 failures (3.18%).ConclusionsThe insertion of implants in smokers significantly affected the failure rates, the risk of postoperative infections as well as the marginal bone loss. The results should be interpreted with caution due to the presence of uncontrolled confounding factors in the included studies.Clinical significanceSmoking is a factor that has the potential to negatively affect healing and the outcome of implant treatment. It is important to perform an updated periodic review to synthesize the clinical research evidence relevant to the matter.