Smoking increases dental implant failures and complications.
METHODS
Medline, Pubmed, Embase and the references of retrieved articles were used to identify relevant data.


METHODS
Clinical studies were included for meta-analysis if they compared implant or patient-related data on failures of implant treatment in relation to the numbers of smokers and nonsmokers. Published clinical studies providing statistically examined data [odds ratios (OR), risk ratios or hazard ratios] of implant failures or biological complications among smokers compared with nonsmokers were included for systemic analysis.


METHODS
Screening of eligible studies was carried out by two independent reviewers. Patient-related studies and implant-related studies were analysed separately. Heterogeneity was investigated and publication bias assessed using funnel plots. Additional data extracted, when available, included the sex of the patient, mandibular or maxillary placement, and any augmentation measures. These dichotomous outcomes were expressed as risk ratios with 95% confidence intervals (CI). Post implant observation periods were categorised for analysis.


RESULTS
In all, 29 studies were included for meta-analysis and 35 for systematic review. Meta-analysis revealed a significantly enhanced risk for implant failure, with or without augmentation, in smokers. The systemic review showed significantly enhanced risks of peri-implant complications and bone loss in smokers. In five studies, in which implants had particle-blasted, acid-etched or anodic oxidised surfaces, smoking had no significant impact on the prognosis of such implants.


CONCLUSIONS
The risk of implant failures and biological complications with and without accompanying augmentation procedures was found to be significantly increased in smokers compared with nonsmokers.
Abt
Elliot
E
Department of Dentistry, Illinois Masonic Medical Center, Chicago, Illinois, USA.