• Am J Prev Med · Jun 2018

    Meta Analysis

    Effect of Smoking on Periodontitis: A Systematic Review and Meta-regression.

    • Fábio R M Leite, Gustavo G Nascimento, Flemming Scheutz, and Rodrigo López.
    • Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark. Electronic address: fabio@dent.au.dk.
    • Am J Prev Med. 2018 Jun 1; 54 (6): 831-841.

    ContextThe study systematically reviewed articles on the association between tobacco smoking and periodontitis, as it has been hypothesized that smoking affects the course of periodontitis through impairment of immunological and vascular mechanisms.Evidence AcquisitionSearches of articles indexed in PubMed, Scopus, and Embase were performed up to and including May 2017. Search strategy included MeSH and free terms: periodontitis, periodontal diseases, smoking, tobacco use, tobacco, tobacco products, cigarette, pipe, and cigar. Only original prospective longitudinal studies that investigated the association between smoking and periodontitis incidence or progression were included. Results were shown as combined risk ratio. Meta-regression and subgroup analyses were used to explore potential sources of heterogeneity. Analyses were conducted in August 2017.Evidence SynthesisTwenty-eight studies were included in the review; of these, only 14 presented data that could be included in the meta-analysis. Pooled adjusted risk ratios estimate that smoking increases the risk of periodontitis by 85% (risk ratio=1.85, 95% CI=1.5, 2.2). Meta-regression demonstrated that age explained 54.2% of the variability between studies, time of follow-up explained 13.5%, loss to follow-up 10.7%, criteria used to assess the periodontal status explained 2.1%, and severity of periodontitis explained 16.9%.ConclusionsSmoking has a detrimental effect on the incidence and progression of periodontitis. Tobacco smoking, therefore, is important information that should be assessed along with other risk factors for periodontitis.Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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