Non-Cochrane · prognostic · PM41776304
Tobacco Smoking and Smoke-Free Products as Risk Factors for Dental Implants: A Systematic Review.
Elena Calciolari, Stefano Corbella, Marina Dourou, et al. · Clinical oral implants research · 2026 · PubMed · doi:10.1111/clr.70108
Findings
16 findings
| Population | ||||
|---|---|---|---|---|
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Implant failure (implant survival as reference; OR < 1 indicates worse survival in smokers), implant level 1 to 5 years · Follow-up 1-5 years | OR 0.37 [0.18, 0.75] GRADE not reported 13 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Implant failure (implant survival as reference; OR < 1 indicates worse survival in smokers), patient level All follow-up times combined (grouped analysis) | OR 0.43 [0.20, 0.90] Low Downgraded: risk of bias, inconsistency 10 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Implant failure (implant survival as reference; OR < 1 indicates worse survival in smokers), patient level More than 5 years · Follow-up > 5 years | OR 0.79 [0.11, 5.72] GRADE not reported 4 studies |
| Adults with dental implants (any loading protocol; with or without bone regeneration) | Current cigarette smokers (smoking exposure) | Non-smokers (never smokers or former smokers quit at least 1 year) | Changes in peri-implant crevicular fluid (PICF) markers Dental implant patients; mixed clinical settings | no estimate extracted No studies found 0 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Implant failure (implant survival as reference; OR < 1 indicates worse survival in smokers), implant level Regardless of follow-up Unresolved: the two extractors disagree on this row. | OR 0.40 [0.27, 0.61] Low Downgraded: risk of bias, inconsistency 36 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Implant failure (implant survival as reference; OR < 1 indicates worse survival in smokers), implant level All follow-up times combined (27 studies, grouped analysis) | OR 0.32 [0.20, 0.51] Low Downgraded: risk of bias, inconsistency 27 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Radiographic peri-implant crestal bone loss (mm) All follow-up times combined (grouped analysis) | MD 0.64 [0.29, 0.99] Low Downgraded: risk of bias, inconsistency 9 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Implant failure (implant survival as reference; OR < 1 indicates worse survival in smokers), implant level 5 to 10 years · Follow-up 5-10 years | OR 0.24 [0.11, 0.51] GRADE not reported 12 studies |
| Adults with dental implants (any loading protocol; with or without bone regeneration) | Current cigarette smokers (smoking exposure) | Non-smokers (never smokers or former smokers quit at least 1 year) | Changes in microbial plaque composition Dental implant patients; mixed clinical settings | no estimate extracted No studies found 0 studies |
| Adults with dental implants (any loading protocol; with or without bone regeneration) | Current cigarette smokers (smoking exposure) | Non-smokers (never smokers or former smokers quit at least 1 year) | Patient-reported outcome measures (PROMs) Dental implant patients; mixed clinical settings | no estimate extracted No studies found 0 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Implant failure (implant survival as reference; OR < 1 indicates worse survival in smokers), implant level 1 year · Follow-up 1 year | OR 0.57 [0.25, 1.33] GRADE not reported 2 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Radiographic peri-implant crestal bone loss (mm) 1 to 5 years · Follow-up 1-5 years | MD 0.10 [0.03, 0.17] GRADE not reported 5 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Implant failure (implant survival as reference; OR < 1 indicates worse survival in smokers), patient level 1 to 5 years · Follow-up 1-5 years | OR 0.38 [0.17, 0.86] GRADE not reported 6 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Radiographic peri-implant crestal bone loss (mm) More than 5 years · Follow-up > 5 years | MD 1.48 [-0.04, 3.01] GRADE not reported 4 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Current cigarette smokers | Non-smokers (never smokers or former smokers) | Radiographic peri-implant crestal bone loss (mm) Not stated (11 studies in GRADE table) | MD 0.58 [-0.10, 1.25] Low Downgraded: risk of bias, inconsistency 11 studies |
| Adults with dental implants (single units to full arches, with or without bone regeneration) | Smoke-free product users (heated tobacco, e-vapor, e-cigarettes, non-inhalable products) | Non-users of smoke-free products or former users | Implant failure/survival and secondary outcomes At least 1 year after loading | Insufficient data are available for smoke-free users; 100% implant survival in the only e-cigarette study and the only waterpipe study (8-year follow-up) GRADE not reported 2 studies |
Included primary studies 45
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Agliardi 2023 Clinical outcomes of full-arch immediate fixed prostheses supported by two axial and two tilted implants: A retrospective cohort study… PMID:36760035 | 2023 | 1 other review | not stated | not extracted yet |
| Alazmi 2021 Comparison of Peri-Implant Clinicoradiographic Parameters among Non-Smokers and Individuals Using Electronic Nicotine Delivery Systems at… PMID:34585877 | 2021 | 1 other review | not stated | not extracted yet |
| Tawil 2008 Conventional and advanced implant treatment in the type II diabetic patient: surgical protocol and long-term clinical results. PMID:18807573 | 2008 | 1 other review | not stated | not extracted yet |
| Abduljabbar 2018 Comparison of peri-implant clinical and radiographic status around short (6 mm in length) dental implants placed in cigarette-smokers and… PMID:29181892 | 2018 | this review only | not stated | not extracted yet |
| Al Amri 2017 Comparison of Peri-Implant Soft Tissue Parameters and Crestal Bone Loss Around Immediately Loaded and Delayed Loaded Implants in Smokers… PMID:27587369 | 2017 | this review only | not stated | not extracted yet |
| Alahmari 2019 Soft tissue status and crestal bone loss around conventionally-loaded dental implants placed in cigarette- and waterpipe (narghile)… PMID:30884091 | 2019 | this review only | not stated | not extracted yet |
| Alghamdi 2020 Peri-implant soft tissue status and crestal bone loss around immediately-loaded narrow-diameter implants placed in cigarette-smokers:… PMID:32157803 | 2020 | this review only | not stated | not extracted yet |
| Alhenaki 2021 Clinical, radiographic and restorative parameters for short tuberosity implants placed in smokers: a retrospective study with 5 year… PMID:34240298 | 2021 | this review only | not stated | not extracted yet |
| Alsaadi 2008 Impact of local and systemic factors on the incidence of late oral implant loss. PMID:18492080 | 2008 | this review only | not stated | not extracted yet |
| Alsahhaf 2019 Survival of Titanium-Zirconium and Titanium Dental Implants in Cigarette-smokers and Never-smokers: A 5-Year Follow-up. PMID:31859286 | 2019 | this review only | not stated | not extracted yet |
| Balaguer 2015 Long-term survival rates of implants supporting overdentures. PMID:23750606 | 2015 | this review only | not stated | not extracted yet |
| Bardis 2023 Assessment of Various Risk Factors for Biological and Mechanical/Technical Complications in Fixed Implant Prosthetic Therapy: A… PMID:37510085 | 2023 | this review only | not stated | not extracted yet |
| Brizuela‐Velasco 2021 Logistic Regression Analysis of the Factors Involved in the Failure of Osseointegration and Survival of Dental Implants with an Internal… PMID:34660803 | 2021 | this review only | not stated | not extracted yet |
| Cakarer 2014 Investigation of the risk factors associated with the survival rate of dental implants. PMID:24776944 | 2014 | this review only | not stated | not extracted yet |
| Castellanos‐Cosano 2021 An evaluation of peri-implant marginal bone loss according to implant type, surgical technique and prosthetic rehabilitation: a… PMID:33496913 | 2021 | this review only | not stated | not extracted yet |
| Cavalcanti 2011 The influence of smoking on the survival of dental implants: a 5-year pragmatic multicentre retrospective cohort study of 1727 patients. PMID:21594218 | 2011 | this review only | not stated | not extracted yet |
| Cha 2014 Simultaneous sinus lift and implant installation: prospective study of consecutive two hundred seventeen sinus lift and four hundred… PMID:23157674 | 2014 | this review only | not stated | not extracted yet |
| Chatzopoulos and Wolff 2023 Retrospective analysis of 50,333 implants on implant failure and associated patient-related factors. PMID:37437663 | 2023 | this review only | not stated | not extracted yet |
| Chrcanovic 2017 Intake of Proton Pump Inhibitors Is Associated with an Increased Risk of Dental Implant Failure. PMID:28632255 | 2017 | this review only | not stated | not extracted yet |
| Deepa 2018 Prognostic Implication of Selective Serotonin Reuptake Inhibitors in Osseointegration of Dental Implants: A 5-year Retrospective Study. PMID:30066689 | 2018 | this review only | not stated | not extracted yet |
| Degidi 2016 10-year prospective cohort follow-up of immediately restored XiVE implants. PMID:26096295 | 2016 | this review only | not stated | not extracted yet |
| Doan 2014 Flapless dental implant surgery: a retrospective study of 1,241 consecutive implants. PMID:24818204 | 2014 | this review only | not stated | not extracted yet |
| Garcia‐Bellosta 2010 Retrospective study of the long-term survival of 980 implants placed in a periodontal practice. PMID:20556263 | 2010 | this review only | not stated | not extracted yet |
| Geurs 2001 Retrospective radiographic analysis of sinus graft and implant placement procedures from the Academy of Osseointegration Consensus… PMID:11693244 | 2001 | this review only | not stated | not extracted yet |
| He 2015 Assessment of implant cumulative survival rates in sites with different bone density and related prognostic factors: an 8-year… PMID:25830396 | 2015 | this review only | not stated | not extracted yet |
| Hong 2020 Implant survival and risk factor analysis in regenerated bone: results from a 5-year retrospective study. PMID:33350178 | 2020 | this review only | not stated | not extracted yet |
| Jesch 2018 An up to 17-year follow-up retrospective analysis of a minimally invasive, flapless approach: 18 945 implants in 7783 patients. PMID:29446204 | 2018 | this review only | not stated | not extracted yet |
| Kandasamy 2018 Long-term Retrospective Study based on Implant Success Rate in Patients with Risk Factor: 15-year Follow-up. PMID:29358541 | 2018 | this review only | not stated | not extracted yet |
| Koldsland 2009 Prevalence of implant loss and the influence of associated factors. PMID:19563286 | 2009 | this review only | not stated | not extracted yet |
| Lin 2012 The effect of cigarette smoking and native bone height on dental implants placed immediately in sinuses grafted by hydraulic condensation. PMID:22408769 | 2012 | this review only | not stated | not extracted yet |
| Malo 2015 All-on-4® Treatment Concept for the Rehabilitation of the Completely Edentulous Mandible: A 7-Year Clinical and 5-Year Radiographic… PMID:25536438 | 2015 | this review only | not stated | not extracted yet |
| Maló 2018 Five-year outcome of a retrospective cohort study comparing smokers vs. nonsmokers with full-arch mandibular implant-supported… PMID:29743383 | 2018 | this review only | not stated | not extracted yet |
| Mangano 2014 Short (8-mm) locking-taper implants supporting single crowns in posterior region: a prospective clinical study with 1-to 10-years of… PMID:23621393 | 2014 | this review only | not stated | not extracted yet |
| Mundt 2006 Private practice results of screw-type tapered implants: survival and evaluation of risk factors. PMID:16955613 | 2006 | this review only | not stated | not extracted yet |
| Nitzan 2005 Impact of smoking on marginal bone loss. PMID:16161745 | 2005 | this review only | not stated | not extracted yet |
| Peleg 2006 Healing in smokers versus nonsmokers: survival rates for sinus floor augmentation with simultaneous implant placement. PMID:16955605 | 2006 | this review only | not stated | not extracted yet |
| Raes 2015 A prospective cohort study on the impact of smoking on soft tissue alterations around single implants. PMID:24798293 | 2015 | this review only | not stated | not extracted yet |
| Rotim 2021 THE EFFECT OF LOCAL AND SYSTEMIC FACTORS ON DENTAL IMPLANT FAILURE - ANALYSIS OF 670 PATIENTS WITH 1260 IMPLANTS. PMID:35282491 | 2022 | this review only | not stated | not extracted yet |
| Sánchez‐Pérez 2007 Tobacco as a risk factor for survival of dental implants. PMID:17274726 | 2007 | this review only | not stated | not extracted yet |
| Sun 2016 Effect of Heavy Smoking on Dental Implants Placed in Male Patients Posterior Mandibles: A Prospective Clinical Study. PMID:27541691 | 2016 | this review only | not stated | not extracted yet |
| Vervaeke 2012 The effect of smoking on survival and bone loss of implants with a fluoride-modified surface: a 2-year retrospective analysis of 1106… PMID:21545531 | 2012 | this review only | not stated | not extracted yet |
| Wach 2023 Is Corticalization in Radiographs Related to a Higher Risk of Bone Loss around Dental Implants in Smoking Patients? A 5-Year Observation… PMID:37629393 | 2023 | this review only | not stated | not extracted yet |
| Windael 2020 The Long-Term Effect of Smoking on 10 Years' Survival and Success of Dental Implants: A Prospective Analysis of 453 Implants in a… PMID:32276371 | 2020 | this review only | not stated | not extracted yet |
| Zhang 2023 Comparison of 4- or 6-implant supported immediate full-arch fixed prostheses: A retrospective cohort study of 217 patients followed up for… PMID:36522852 | 2023 | this review only | not stated | not extracted yet |
| Zuffetti 2020 A Retrospective Multicenter Study on Short Implants With a Laser-Microgrooved Collar (≤7.5 mm) in Posterior Edentulous Areas: Radiographic… PMID:31518549 | 2020 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults (>18 years) who received dental implants (single units to full arches), including concomitant or prior bone regeneration | Adults with dental implants (44 studies; 45 articles; 37 in meta-analysis) |
| Intervention | FQ1: current tobacco smokers (cigarettes, pipes, cigars, bidis, hookah) or smokers who quit during the study; FQ2: current smoke-free users (heated tobacco, e-cigarettes, vapers, non-inhalable products) | Cigarette smokers (41 studies); cigarettes and waterpipe (n=1); e-cigarettes (n=1); unspecified cigarettes (n=1) |
| Comparison | Never smokers or former smokers (quit at least 1 year); for FQ2 non-users or former users | Non-smokers |
| Outcomes | Primary: implant failure/survival at least 1 year post-loading; secondary: peri-implant mucositis and peri-implantitis, crestal bone loss, other biological complications, PICF markers, microbial plaque composition, PROMs | Implant failure/survival at implant level (n=36) and patient level (n=10); crestal bone loss (n=18 studies, meta-analysis of 9); peri-implant diseases and biological complications (narrative, 15 studies); PROMs, PICF markers, microbial composition: no studies |
| Study designs | RCTs, CCTs, case-control (min 30 patients), cross-sectional (FQ2), cohort studies (min 30 patients) | 8 prospective and 35 retrospective studies, plus 1 study with retrospective then prospective follow-up |
| Timing | At least 1 year follow-up post-implant loading | Follow-up 1 to 17 years |