|
Title |
Tobacco Smoking Negatively Affects Implant Survival |
Clinical Question |
In an otherwise healthy adult, does smoking tobacco increase the risk of intraosseous dental implant failure? |
Clinical Bottom Line |
Smoking tobacco does increase the risk for intraosseous implant failure, due primarily to exposure of the peri-implant tissue to tobacco smoke. (See Comments on the CAT below) |
Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
#1) 16907781 | Hinode/2006 | 19 different studies patients | Meta-Analysis | Key results | The odds ratio for osseointegrated implant failure in smoking patients was elevated compared to nonsmokers. (OR 2.17 Confidence Interval 95%) | #2) 11885185 | Lambert/2000 | 800 adults at 32 different centers | Retrospective Cohort Study | Key results | Over the three-year period failures were “significantly” higher for smokers than non-smokers". | #3) 17509093 | Strietzel/2007 | Articles must have included odds ratios, hazard ratios, or risk ratios among smokers who had failed implants, or reports of complications which affected implant success | Systematic review and meta-analysis | Key results | Meta-analysis revealed a significantly enhanced risk for implant failure among smokers: [implant-related odds ratio (OR) 2.25, confidence interval (CI(95%)) 1.96-2.59; patient-related OR 2.64; CI(95%) 1.70-4.09] compared with non-smokers, and for smokers receiving implants with accompanying augmentation procedures (OR 3.61; CI(95%) 2.26-5.77, implant related). Systematic review showed higher risk of complications associated with smoking groups, however, five studies in which particle blasted, acid etched or anodic oxidized surface implants were used there was no significant difference between groups. | |
Evidence Search |
Meta-Analysis, Randomized Controlled TrialSearch Limits: Meta-Analysis, Randomized Controlled TrialSearch, Search smoking [Mesh]Search dental implants [Mesh] |
Comments on
The Evidence |
The groups in the Lambert study were similar at the start of the study, separated into smokers and non-smokers. There was adequate compliance and there was no recall bias or competing interests evident. The Hinode and Strietzel papers were systematic reviews with Meta-Analysis |
Applicability |
The results from these articles are highly suggestive of the influence smoking has on implant failure and apply significantly to patients considering implants whom smoke tobacco. |
Specialty/Discipline |
(Endodontics) (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) (Dental Hygiene) (Behavioral Science) |
Keywords |
Smoking, Implant, Tobacco, Prognosis
|
ID# |
563 |
Date of submission: |
04/14/2010 Revised: 09/19/2011 |
E-mail |
allisonr@livemail.uthscsa.edu |
Author |
Ryan Allison |
Co-author(s) |
Joshua R. Chapa |
Co-author(s) e-mail |
|
Faculty mentor/Co-author |
Kenneth Kalkwarf, DDS, MS |
Faculty mentor/Co-author e-mail |
KALKWARF@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Emily Sexton (San Antonio, TX) on 09/30/2021 I have conducted a PubMed search on this topic in September 2021 and found a more recent publication: Moraschini 2016, PubMed ID: 26385308. The meta-analysis further supports the conclusions of this CAT. | by Matt Checketts (San Antonio, TX) on 07/12/2011 I have repeated a search on PubMed to validate these findings. The conclusions reached in this analysis are still current and correct. | |
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