Non-Cochrane · aetiology · PM42591600
Association between smoking cessation and periodontitis progression: a systematic review and meta-analysis of prospective observational studies.
Xie Yangyang, Ma Ya, Geng Zhen, et al. · Frontiers in oral health · 2026 · PubMed · doi:10.3389/froh.2026.1900393
Findings
Population Patients with periodontitis who were smokers
24 findings
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Probing depth (PD) 12 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -0.52 [-1.26, 0.23] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Bleeding on probing (BOP) 12 months | SMD -0.31 [-0.80, 0.18] Very low Downgraded: imprecision 2 studies · 71 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Probing depth (PD) 6 months | SMD -1.50 [-2.45, -0.55] Very low Downgraded: imprecision, inconsistency 4 studies · 671 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Clinical attachment level (CAL) 6 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -0.42 [-0.90, 0.07] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Probing depth (PD) 6 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -1.99 [-2.59, -1.40] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Clinical attachment level (CAL) 3 months | SMD -0.78 [-1.39, -0.16] Very low Downgraded: imprecision, inconsistency 3 studies · 472 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Plaque index (PI) 3 months | SMD -1.12 [-3.82, 1.57] Very low Downgraded: imprecision, inconsistency 2 studies · 468 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Plaque index (PI) 12 months | SMD -2.36 [-7.49, 2.78] Very low Downgraded: imprecision, inconsistency 2 studies · 468 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Bleeding on probing (BOP) 3 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -0.15 [-0.64, 0.34] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Clinical attachment level (CAL) 6 months | SMD -0.84 [-1.80, 0.11] Very low Downgraded: imprecision, inconsistency 3 studies · 472 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Clinical attachment level (CAL) 12 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -0.17 [-0.70, 0.37] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Probing depth (PD) 3 months | SMD -1.08 [-1.84, -0.31] Very low Downgraded: imprecision, inconsistency 3 studies · 471 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Bleeding on probing (BOP) 6 months | SMD -0.14 [-0.63, 0.34] Very low Downgraded: imprecision 2 studies · 71 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Bleeding on probing (BOP) Summary (all follow-up; longest 10 years) | SMD -0.10 [-0.45, 0.26] Very low Downgraded: imprecision 3 studies · 139 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Bleeding on probing (BOP) 6 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -0.14 [-0.63, 0.34] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Bleeding on probing (BOP) Summary (all follow-up; longest 10 years) · Sensitivity analysis: studies omitted (Appendix 10) | SMD 0.05 [-0.38, 0.47] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Bleeding on probing (BOP) 3 months | SMD -0.15 [-0.64, 0.34] Very low Downgraded: imprecision 2 studies · 71 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Probing depth (PD) 3 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -0.62 [-1.12, -0.12] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Plaque index (PI) 6 months | SMD -1.47 [-4.87, 1.92] Very low Downgraded: imprecision, inconsistency 2 studies · 468 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Bleeding on probing (BOP) 12 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -0.31 [-0.80, 0.18] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Plaque index (PI) 9 months | SMD -1.83 [-5.92, 2.26] Very low Downgraded: imprecision, inconsistency 2 studies · 468 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Clinical attachment level (CAL) 12 months | SMD -0.93 [-2.61, 0.74] Very low Downgraded: imprecision, inconsistency 3 studies · 472 participants |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Clinical attachment level (CAL) 3 months · Sensitivity analysis: studies omitted (Appendix 10) | SMD -0.43 [-0.92, 0.06] GRADE not reported Studies not reported |
| Smoking cessation (quitters) | Continued smoking (non-quitters) | Probing depth (PD) 12 months | SMD -1.54 [-3.40, 0.32] Very low Downgraded: imprecision, inconsistency 3 studies · 471 participants |
Included primary studies 6
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Okamoto 2006 Effects of smoking and drinking habits on the incidence of periodontal disease and tooth loss among Japanese males: a 4-yr longitudinal… PMID:17076782 | 2006 | 1 other review | not stated | not extracted yet |
| Preshaw 2005 The effect of quitting smoking on chronic periodontitis. PMID:15998271 | 2005 | 1 other review | not stated | not extracted yet |
| Rosa 2011 A prospective 12-month study of the effect of smoking cessation on periodontal clinical parameters. PMID:21488933 | 2011 | 1 other review | not stated | not extracted yet |
| Bergström 2000 A 10-year prospective study of tobacco smoking and periodontal health. PMID:10972650 | 2000 | this review only | not stated | not extracted yet |
| Dixit 2024 Effect of Smoking Cessation Programs on Periodontal Disease Progression. PMID:38595512 | 2024 | this review only | not stated | not extracted yet |
| Rashid 2024 Assessing the Impact of Smoking Cessation Interventions on Periodontal Health and Gingival Inflammation in Smokers with Periodontitis. PMID:38595419 | 2024 | 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 | Patients with periodontitis; exclusion of periodontal treatment within 6 months before cessation | Smokers with periodontitis (n=1,934 across 6 studies) |
| Intervention | Smoking cessation regardless of modality (counseling, pharmacotherapy) | Smoking cessation: counseling, nicotine replacement therapy, pharmacotherapy (quitters) |
| Comparison | Continued smoking | Continued smoking (non-quitters, current smokers) |
| Outcomes | Primary: probing depth; secondary: clinical attachment level, bleeding on probing, plaque index; oral measurements: alveolar bone loss, tooth loss, plaque score, gingival inflammation | Probing depth (4 studies); clinical attachment level (3); bleeding on probing (3); plaque index (2); alveolar bone loss, tooth loss, plaque score and gingival inflammation reported narratively |
| Study designs | Prospective observational studies; follow-up of at least 3 months; English or Chinese | 6 prospective observational studies (5 in meta-analysis) |
| Timing | 3, 6, 9 and 12 months | 3, 6, 9 and 12 months; longest 10 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | NR | Yes | no |
| 2Protocol established before the reviewcritical | NR | Partial Yes | no |
| 3Choice of study designs explained | NR | Yes | no |
| 4Comprehensive literature searchcritical | NR | Partial Yes | no |
| 5Study selection in duplicate | NR | Yes | no |
| 6Data extraction in duplicate | NR | Yes | no |
| 7List of excluded studies with reasonscritical | NR | Yes | no |
| 8Included studies described in detail | NR | Partial Yes | no |
| 9Risk of bias assessed satisfactorilycritical | NR | NRSI: Yes | no |
| 10Funding of included studies reported | NR | No | no |
| 11Appropriate meta-analysis methodscritical | NR | NRSI: No | no |
| 12Impact of risk of bias on the pooled results | NR | No | no |
| 13Risk of bias accounted for in interpretationcritical | NR | Yes | no |
| 14Heterogeneity explained | NR | Yes | no |
| 15Publication bias investigatedcritical | NR | No | no |
| 16Conflicts of interest reported | NR | Yes | no |
| Overall | NR | Critically Low | no |