The impact of smoking on non-surgical periodontal therapy: A systematic review and meta-analysis

J Clin Periodontol. 2021 Jan;48(1):60-75. doi: 10.1111/jcpe.13384. Epub 2020 Nov 5.

Abstract

Aim: Smoking is a risk factor for periodontitis. This study aimed to evaluate the impact of smoking on clinical outcomes of non-surgical periodontal therapy.

Materials and methods: Electronic databases were searched to screen studies published before May 2020. The included studies had to have two groups: smokers (S) and non-smokers (NS) with periodontitis. The outcomes evaluated were differences between groups in probing depth (PD) reduction and clinical attachment level (CAL) gain after non-surgical periodontal therapy. Meta-regressions were conducted to evaluate correlations between outcomes and other contributing factors.

Results: Seventeen studies were included. The post-treatment PD reduction in the S group was smaller than in the NS group (weighted mean difference in PD reduction: -0.33 mm, 95% confidence interval (CI): [-0.49, -0.17], p < .01). The CAL gain in the S group was also smaller than in the NS group (weighted mean difference in CAL gain: -0.20 mm, CI: [-0.39, -0.02], p < .01). Additionally, baseline PD significantly affected the difference in PD reduction between two groups.

Conclusions: Smoking negatively impacts clinical responses to non-surgical periodontal therapy. Smokers with periodontitis have significantly less PD reduction and CAL gain than non-smokers.

Keywords: cigarette smoking; dental scaling; evidence-based dentistry; root planning; treatment outcome.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Chronic Periodontitis* / therapy
  • Dental Scaling
  • Humans
  • Periodontal Attachment Loss / therapy
  • Root Planing
  • Smokers
  • Smoking / adverse effects