Aim The present systematic review and meta‐analysis was performed to investigate if there was a significantly enhanced risk of dental implant failure due to the increased number of cigarettes smoked per day. Materials and Methods Four databases, including PubMed, Embase, Web of Science and Scopus, were searched until January, 2019. The search terms “dental implant, oral implant, smoking, smoker, tobacco, nicotine and non‐smoker” were used in combination to identify the publications providing data for dental implant failures related to the smoking habit. Publications were excluded if the quantity of cigarettes consumed per day was not reported. Fixed‐ or random‐effects meta‐analyses were used to pool the estimates of relative risk (RR) with 95% confidence intervals (CI). Results Having additional information supplied by the authors, 23 articles were selected for final analysis. The meta‐analyses based on implant‐ and patient‐related data showed a significant increase in the RR of implant failure in patients who smoked >20 cigarettes per day compared with non‐smokers (implant based: p = .001; RR: 2.45; CI: 1.42–4.22 and patient based: p < .001; RR: 4; CI: 2.72–5.89). Conclusion The risk of implant failure was elevated with an increase in the number of cigarettes smoked per day.

Background:The role of host response in periodontitis pathogenesis is confirmed, and it is well established that immune response plays a major role in the alveolar bone destruction. In the investigation of these responses, the role of receptor activator of the nuclear factor-kB ligand (RANKL)-osteoprotegerin (OPG) system is the most promising. Smoking can affect the RANKL-OPG system in a manner that will further enhance bone loss in periodontitis. The aim of this study is to assess the serum, saliva, and gingival crevicular fluid (GCF) concentration of RANKL and OPG in smoker versus nonsmoker untreated chronic periodontitis (CP) patients.Materials and Methods:Thirty-nine subjects were included in the present cross-sectional study: 29 systemically healthy CP male patients (15 smokers, 14 nonsmokers) and 10 systemically and periodontally healthy nonsmoker male subjects. Serum, GCF, and whole saliva samples were obtained from the subjects. The enzyme-linked immunosorbent assay (ELISA) kits were used for assaying the concentrations of RANKL and OPG in the samples. The one-way analysis of variance (ANOVA) test and the least significant difference (LSD) post hoc test were utilized to compare differences between the groups.Results:RANKL and OPG concentrations in saliva, serum, and GCF did not show any significant difference among all groups (P > 0.05). Salivary RANKL/OPG ratios were significantly higher in the nonsmoker CP group than in the healthy control group (P > 0.05) but they were not statistically significant among smoker periodontitis patients.Conclusions:The salivary RANKL/OPG ratio was higher in nonsmokers with periodontitis in comparison with smoker periodontitis patients.

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