LEVELS OF SMOKING AND PERI-IMPLANT MARGINAL BONE LOSS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Aim This systematic review and meta-analysis sought to determine if there was a sig-nificantly enhanced risk of peri-implant marginal bone loss (MBL) due to the in-creased number of cigarettes smoked per day. Materials and Methods Six databases, including Medline, Embase, Cochrane Library, Web of Science, Scopus, and ProQuest, were searched until February , 2021. The search terms "dental implant, oral implant, smoking, smoker, non-smoker, marginal bone loss and crestal bone loss" were used in combination to seek the articles providing data for MBL related to the smoking habit. Articles were excluded if the quantity of cigarettes smoked per day was not reported. Random-effects meta-analyses were used to pool the estimates of mean difference (MD) with 95% confidence intervals (CI). Results Eight studies were included for qualitative and 5 for quantitative synthesis. The meta-analyses revealed higher levels of MBL in patients who smoked < 10 or > 10 cigarettes/day than in non-smokers ( < 10: (MD-0.33, 95% CI-0.69-0.03 and > 10: MD-0.58, 95% CI -0.96--0.19).There was a significant risk of MBL between patients who smoked > 10 and < 10 cigarettes/day (MD-0.23, 95% CI-0.47-0.01). Conclusion It seems the risk of MBL is steadily increasing as daily smoking increases.