Smoking and the risk of peri-implantitis. A systematic review and meta-analysis.
OBJECTIVE
The aim of this systematic review and meta-analysis was to assess the role of smoking as a risk factor for peri-implantitis.


METHODS
Six electronic databases and a manual search resulted in 5876 unique publications. After selection, only seven studies were included in the systematic review. Dichotomous data were expressed as risk ratios (RRs) and 95% confidence intervals (CIs). A generic inverse variance statistical model was used. Due to the expected interstudy heterogeneity, a random effect model was used for both data types. Heterogeneity was assessed with the Cochrane χ(2) and I(2) tests. The pooled effect was considered significant for a P-value <0.05.


RESULTS
The implant-based meta-analysis revealed a higher and significant risk of peri-implantitis in smokers (RR: 2.1, 95% CI: 1.34-3.29, P = 0.001) compared with nonsmokers, but the patient-based meta-analysis did not reveal any significant differences for risk of peri-implantitis in smokers (RR: 1.17, 95% CI: 0.78-1.75, P = 0.46). No evidence of significant heterogeneity was detected for the two analyses (χ(2) = 0.64, P = 0.89; I(2) = 0% and χ(2) = 2.44, P = 0.30; I(2) = 18%, respectively, for implant- and patient-based meta-analyses).


CONCLUSIONS
There is little evidence that smoking is a risk factor for peri-implantitis. However, given the low number of included studies, future studies are needed to confirm these results.
School of Dentistry, Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Fabrizio
F
Sgolastra
School of Dentistry, Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Ambra
A
Petrucci
School of Dentistry, Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Marco
M
Severino
School of Dentistry, Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Roberto
R
Gatto
School of Dentistry, Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Annalisa
A
Monaco
D006801:Humans; D057873:Peri-Implantitis / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
meta-analysis; peri-implantitis; smoking; systematic review; tobacco