History of treated periodontitis and smoking as risks for implant therapy.
OBJECTIVE
The aim of this review was to evaluate a history of treated periodontitis and smoking, both alone and combined, as risk factors for adverse dental implant outcomes.


METHODS
A literature search of MEDLINE (Ovid) and EMBASE from January 1, 1966, to June 30, 2008, was performed, and the outcome variables implant survival, implant success, occurrence of peri-implantitis and marginal bone loss were evaluated.


RESULTS
Considerable heterogeneity in study design was found, and few studies accounted for confounding variables. For patients with a history of treated periodontitis, the majority of studies reported implant survival rates > 90%. Three cohort studies showed a higher risk of peri-implantitis in patients with a history of treated periodontitis compared with those without a history of periodontitis (reported odds ratios from 3.1 to 4.7). In three of four systematic reviews, smoking was found to be a significant risk for adverse implant outcome. While the majority of studies reported implant survival rates ranging from 80% to 96% in smokers, most studies found statistically significantly lower survival rates than for nonsmokers.


CONCLUSIONS
There is an increased risk of peri-implantitis in smokers compared with nonsmokers (reported odds ratios from 3.6 to 4.6). The combination of a history of treated periodontitis and smoking increases the risk of implant failure and peri-implant bone loss.
Heitz-Mayfield
Lisa J A
LJ
Centre for Rural and Remote Oral Health, The University of Western Australia, Crawley, WA, Australia. heitz.mayfield@iinet.au
Huynh-Ba
Guy
G
D000075202:Contraindications; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019232:Dental Restoration Failure; D006801:Humans; D010518:Periodontitis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
D015921:Dental Implants