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Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis.

Chen H, Liu N, Xu X, Qu X, Lu E - PLoS ONE (2013)

Bottom Line: References of relevant studies were also searched.A random-effects meta-analysis was used to pool estimates of relative risks (RRs) with 95% confidence intervals (CIs).The subgroup analysis indicated no influence of study design, geographical location, length of follow-up, sample size, or mean age of recruited patients.

View Article: PubMed Central - PubMed

Affiliation: College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

ABSTRACT

Background: There are conflicting reports as to the association between smoking, radiotherapy, diabetes and osteoporosis and the risk of dental implant failure. We undertook a meta-analysis to evaluate the association between smoking, radiotherapy, diabetes and osteoporosis and the risk of dental implant failure.

Methods: A comprehensive research on MEDLINE and EMBASE, up to January 2013, was conducted to identify potential studies. References of relevant studies were also searched. Screening, data extraction and quality assessment were conducted independently and in duplicate. A random-effects meta-analysis was used to pool estimates of relative risks (RRs) with 95% confidence intervals (CIs).

Results: A total of 51 studies were identified in this meta-analysis, with more than 40,000 dental implants placed under risk-threatening conditions. The pooled RRs showed a direct association between smoking (n = 33; RR = 1.92; 95% CI, 1.67-2.21) and radiotherapy (n = 16; RR = 2.28; 95% CI, 1.49-3.51) and the risk of dental implant failure, whereas no inverse impact of diabetes (n = 5; RR = 0.90; 95% CI, 0.62-1.32) on the risk of dental implant failure was found. The influence of osteoporosis on the risk of dental implant failure was direct but not significant (n = 4; RR = 1.09; 95% CI, 0.79-1.52). The subgroup analysis indicated no influence of study design, geographical location, length of follow-up, sample size, or mean age of recruited patients.

Conclusions: Smoking and radiotherapy were associated with an increased risk of dental implant failure. The relationship between diabetes and osteoporosis and the risk of implant failure warrant further study.

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Flow Diagram of Screened and Included Papers.
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pone-0071955-g001: Flow Diagram of Screened and Included Papers.

Mentions: The literature search yielded a total of 3,735 primary studies, of which 3,472 were excluded after title screening. An additional 65 studies were included after checking the references of relevant reviews and studies. Finally, 328 studies were included for full-text assessment, of which 277 were excluded for one of the following reasons: (1) studies focusing on irrelevant outcome assessment (n = 144), such as bone loss or primary stability; (2) studies without a non-risk group (n = 56); (3) studies only providing patient-related data (n = 21); (4) studies where data related to implant failure could not be calculated (n = 53); and (5) studies where the reported data were represented in another included in our analysis (n = 3) [19]–[21]. As a result, 51 studies met the inclusion criteria for meta-analysis, with 33 studies for smoking [22]–[54], 16 for radiotherapy [31], [44], [55]–[68], five for diabetes [31], [44], [47], [48], [69] and four for osteoporosis [44], [70]–[72], respectively. Of note, four studies involved more than one risk factor and were included in more than one group [31], [44], [47], [48]. A flow diagram of the study selection process is presented in Figure 1.


Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis.

Chen H, Liu N, Xu X, Qu X, Lu E - PLoS ONE (2013)

Flow Diagram of Screened and Included Papers.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3733795&req=5

pone-0071955-g001: Flow Diagram of Screened and Included Papers.
Mentions: The literature search yielded a total of 3,735 primary studies, of which 3,472 were excluded after title screening. An additional 65 studies were included after checking the references of relevant reviews and studies. Finally, 328 studies were included for full-text assessment, of which 277 were excluded for one of the following reasons: (1) studies focusing on irrelevant outcome assessment (n = 144), such as bone loss or primary stability; (2) studies without a non-risk group (n = 56); (3) studies only providing patient-related data (n = 21); (4) studies where data related to implant failure could not be calculated (n = 53); and (5) studies where the reported data were represented in another included in our analysis (n = 3) [19]–[21]. As a result, 51 studies met the inclusion criteria for meta-analysis, with 33 studies for smoking [22]–[54], 16 for radiotherapy [31], [44], [55]–[68], five for diabetes [31], [44], [47], [48], [69] and four for osteoporosis [44], [70]–[72], respectively. Of note, four studies involved more than one risk factor and were included in more than one group [31], [44], [47], [48]. A flow diagram of the study selection process is presented in Figure 1.

Bottom Line: References of relevant studies were also searched.A random-effects meta-analysis was used to pool estimates of relative risks (RRs) with 95% confidence intervals (CIs).The subgroup analysis indicated no influence of study design, geographical location, length of follow-up, sample size, or mean age of recruited patients.

View Article: PubMed Central - PubMed

Affiliation: College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

ABSTRACT

Background: There are conflicting reports as to the association between smoking, radiotherapy, diabetes and osteoporosis and the risk of dental implant failure. We undertook a meta-analysis to evaluate the association between smoking, radiotherapy, diabetes and osteoporosis and the risk of dental implant failure.

Methods: A comprehensive research on MEDLINE and EMBASE, up to January 2013, was conducted to identify potential studies. References of relevant studies were also searched. Screening, data extraction and quality assessment were conducted independently and in duplicate. A random-effects meta-analysis was used to pool estimates of relative risks (RRs) with 95% confidence intervals (CIs).

Results: A total of 51 studies were identified in this meta-analysis, with more than 40,000 dental implants placed under risk-threatening conditions. The pooled RRs showed a direct association between smoking (n = 33; RR = 1.92; 95% CI, 1.67-2.21) and radiotherapy (n = 16; RR = 2.28; 95% CI, 1.49-3.51) and the risk of dental implant failure, whereas no inverse impact of diabetes (n = 5; RR = 0.90; 95% CI, 0.62-1.32) on the risk of dental implant failure was found. The influence of osteoporosis on the risk of dental implant failure was direct but not significant (n = 4; RR = 1.09; 95% CI, 0.79-1.52). The subgroup analysis indicated no influence of study design, geographical location, length of follow-up, sample size, or mean age of recruited patients.

Conclusions: Smoking and radiotherapy were associated with an increased risk of dental implant failure. The relationship between diabetes and osteoporosis and the risk of implant failure warrant further study.

Show MeSH
Related in: MedlinePlus