This latest critical summary from the ADA-EBD Center for Evidence-Based Dentistry looks at a review by Patel et al 2011 which addresses the question of whether smokers have poorer bone regeneration than non-smokers after periodontal treatment.
The appraiser considered this to be a well-conducted systematic review and meta-analysis that included 10 articles with 458 participants (154 smokers and 304 nonsmokers). While the original reviewers noted substantial heterogeneity the appraiser did not think that this was well handled. The risks of publication bias were not investigated and there was limited information on the design and quality of the included and excluded studies.
While the original reviewer concluded that bone regeneration was poorer following periodontal treatment in patients who smoked the appraiser did not consider this that this conclusion was directly supported by the results. Their overall assessment being
Results from studies with moderate to high risk of bias consistently suggest that smoking will have a negative effect on periodontal bone regeneration after periodontal treatment.
In my blog on May 3rd a number of other reviews that have looked at smoking and periodontal outcomes were highlighted.
Patel RA, Wilson RF, Palmer RM. The effect of smoking on periodontal bone regeneration: a systematic review and meta-analysis. J Periodontol. 2012 Feb;83(2):143-55. doi: 10.1902/jop.2011.110130. Epub 2011 May 31. Review. PubMed PMID: 21627463.