Isabella Neme Ribeiro dos Reis

Peri-implantitis is a plaque-associated pathological condition affecting tissues around dental implants, characterized by inflammation of the peri-implant mucosa and progressive bone loss. Prevalence rates of peri-implant mucositis (precursor of peri-implantitis) and peri-implantitis are estimated to be high. As peri-implantitis is irreversible, presents rapid progression, and challenging treatment, preventive approaches are essential, which include identifying and managing risk factors for its onset and progression. This systematic review focused on analysing smoking as a potential risk factor for peri-implantitis and is the first that included only prospective cohort studies to assess the influence of smoking on peri-implantitis development. The search was performed in the National Library of Medicine (MEDLINE-PubMed), SCOPUS, EMBASE, and ISI Web of Science databases. Two authors independently conducted literature searches, screened, analysed data, and assessed bias. The results were summarized through random effects meta-analyses. The GRADE approach was used to determine the certainty of evidence. A total of 6 studies with 702 patients and 1959 implants were included for analysis. The meta-analysis revealed a significant difference between smokers and non-smokers for the risk of peri-implantitis in the implant-based (p < .0001) and patient-based analysis (p = .003). A strong association between smoking and the risk for peri-implantitis was verified at the implant level (RR: 2.04, 95% CI: 1.46–1.85) and the patient level (RR: 2.79, 95% CI: 1.42–5.50). Moderate certainty evidence suggests that smoking is associated with peri-implantitis compared to non-smoking at the patient and implant levels. Dental professionals should advise and promote smoking cessation, considering its impact on the incidence of peri-implantitis beyond the numerous harmful consequences smoking causes on oral and general health.

I am Isabella Neme Ribeiro dos Reis, 30 years old, Brazilian. A dentist, passionate clinician, and researcher. I am a PhD student in Periodontics at the University of São Paulo and have conducted part of my studies, as a guest PhD, at Aarhus University, Denmark. As a specialist in Implant Dentistry, Periodontics, and Prosthodontics, I actively practice in these areas at a private practice. Alongside my clinical work, I also coordinate and teach in a periodontal and peri-implant plastic surgery course. My research interests primarily revolve around clinical research and systematic reviews, with a focus on peri-implant diseases and their risk factors, hard and soft tissue management, and implants in aesthetic areas. Throughout my academic journey, I have authored peer-reviewed papers and books related to my areas of expertise, as well as actively participated in book chapters and presented several abstracts at scientific events. My dedication to research has earned me prizes and grants, which has allowed me to further contribute to the field.