The influence of smoking on the incidence of peri‐implantitis: A systematic review and meta‐analysis

Abstract Objective The aim of this study was to systematically analyze the influence of smoking on the incidence of peri‐implantitis. Materials and Methods The search was performed in the National Library of Medicine (MEDLINE‐PubMed), SCOPUS, EMBASE, and ISI Web of Science databases (finished on November 30, 2022). Systematic review and meta‐analysis were conducted according to PRISMA statement. Prospective cohort studies that evaluate the incidence of peri‐implantitis in smokers and non‐smokers were included. Two authors independently searched for eligible studies, screened titles, and abstracts, did the full‐text analysis, extracted data, and performed the risk‐of‐bias assessment. The results were summarized through random‐effects meta‐analyses. The GRADE method was used to determine the certainty of evidence. Results A total of 7 studies with 702 patients and 1959 implants were included for analysis. The meta‐analysis revealed a significant difference between smokers and non‐smokers for the risk of peri‐implantitis in the implant‐based ( p < .0001) and patient‐based analysis ( p = .003). A strong association between smoking and the risk for peri‐implantitis was verified at the implant level (RR: 2.04, 95% CI: 1.46–1.85) and the patient level (RR: 2.79, 95% CI: 1.42–5.50). Conclusions Moderate certainty evidence suggests that smoking is associated with peri‐implantitis compared to non‐smoking at the patient and implant levels.