title: Smoking and dental implants: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Recent 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.
  
  
  METHODS
  Main search terms used in combination: dental implant, oral implant, smoking, tobacco, nicotine, smoker, and non-smoker.
  
  
  METHODS
  An electronic search was undertaken in September/2014 in PubMed/Medline, Web of Science, Cochrane Oral Health Group Trials Register plus hand-searching.
  
  
  METHODS
  Eligibility 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%).
  
  
  CONCLUSIONS
  The 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.
  
  
  CONCLUSIONS
  Smoking 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.
authors.affiliation: Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden. Electronic address: bruno.chrcanovic@mah.se.
authors.forename: Bruno Ramos
authors.initials: BR
authors.lastname: Chrcanovic
authors.affiliation: Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Biomaterials, Göteborg University, Göteborg, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Albrektsson
authors.affiliation: Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Wennerberg
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology; D015921:Dental Implants; D019232:Dental Restoration Failure; D006801:Humans; D010510:Periodontal Diseases / Q000209:etiology; D012907:Smoking / Q000009:adverse effects*
chemical_list: D015921:Dental Implants
keywords: Dental implants; Implant failure rate; Marginal bone loss; Meta-analysis; Postoperative infection; Smoking