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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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Forest plot of studies with dental implant failure risk for smoking versus non-smoking patients.The combined Relative risks (RR) and 95% confidence intervals (CIs) were calculated using the random-effects model.
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pone-0071955-g002: Forest plot of studies with dental implant failure risk for smoking versus non-smoking patients.The combined Relative risks (RR) and 95% confidence intervals (CIs) were calculated using the random-effects model.

Mentions: The multivariable-adjusted RRs in each study and the pooled RRs of dental implant failure for smoking versus non-smoking patients are presented in Figure 2, Table 2 and Table 6 (33 studies; 35,118 implants). In the pooled analysis, smoking was associated with higher risk of dental implant failure (RR = 1.92; 95% CI, 1.67–2.21). There was moderate heterogeneity among the studies (P = 0.03, I2 = 35%). Stratifying by study design, the pooled RRs for prospective studies and retrospective studies were 1.34 (95% CI, 0.90–2.00) and 2.01 (95% CI, 1.75–2.30). Stratifying by geographical location, the summary RRs were 1.59 (95% CI, 1.27–1.98) for studies conducted in the United States, 2.27 (95% CI, 1.62–3.20) for Europe and 2.23 (95% CI, 1.77–2.81) for other regions. With regard to the mean age of patients, the pooled RRs for <55-year-old and ≥55-year-old patients were 2.15 (95% CI, 1.87–2.47) and 1.67 (95% CI, 1.13–2.47), respectively. A subgroup analysis indicated no influence of study design, geographical location, length of follow-up, sample size or mean patient age.


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)

Forest plot of studies with dental implant failure risk for smoking versus non-smoking patients.The combined Relative risks (RR) and 95% confidence intervals (CIs) were calculated using the random-effects model.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0071955-g002: Forest plot of studies with dental implant failure risk for smoking versus non-smoking patients.The combined Relative risks (RR) and 95% confidence intervals (CIs) were calculated using the random-effects model.
Mentions: The multivariable-adjusted RRs in each study and the pooled RRs of dental implant failure for smoking versus non-smoking patients are presented in Figure 2, Table 2 and Table 6 (33 studies; 35,118 implants). In the pooled analysis, smoking was associated with higher risk of dental implant failure (RR = 1.92; 95% CI, 1.67–2.21). There was moderate heterogeneity among the studies (P = 0.03, I2 = 35%). Stratifying by study design, the pooled RRs for prospective studies and retrospective studies were 1.34 (95% CI, 0.90–2.00) and 2.01 (95% CI, 1.75–2.30). Stratifying by geographical location, the summary RRs were 1.59 (95% CI, 1.27–1.98) for studies conducted in the United States, 2.27 (95% CI, 1.62–3.20) for Europe and 2.23 (95% CI, 1.77–2.81) for other regions. With regard to the mean age of patients, the pooled RRs for <55-year-old and ≥55-year-old patients were 2.15 (95% CI, 1.87–2.47) and 1.67 (95% CI, 1.13–2.47), respectively. A subgroup analysis indicated no influence of study design, geographical location, length of follow-up, sample size or mean patient age.

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