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DOI: 10.1055/s-0045-1811203
Impact of Cigarette Smoking on Peri-implant Cytokine Profiles: A Systematic Review and Meta-analysis

Abstract
Studies have suggested that cigarette smoking may increase inflammation around dental implants by inducing higher levels of proinflammatory cytokines in diseased and healthy implants. The purpose of this article is to systematically compare peri-implant cytokine profiles around healthy and diseased implants in smokers versus non-smokers. Using appropriate MeSH and keywords, an online search was conducted for prospective clinical studies in which the peri-implant cytokines in healthy and diseased dental implants in smokers were compared with those in non-smokers. The data and outcomes were tabulated, and the quality of the literature was assessed. Meta-analysis was conducted on cytokines that had been evaluated in more than one study. Of the 1,592 items, 10 articles were included in this review. In heathy dental implants, cigarette smoking had a statistically insignificant effect on the cytokine profile. During peri-implantitis, smoking had a more significant effect on the levels of proinflammatory cytokines such as IL-1β and MMP-9, but there was significant heterogeneity between the studies and the sample size was not adequate to ascertain the overall long-term impact. Nine out of 10 studies in this review had several sources of bias and were of low quality, and one study had a moderate quality. Within the limits of this systematic review, it may be suggested that cigarette smoking aggravates peri-implantitis by influencing the cytokine profile to proinflammatory. The effect of cigarette smoking on clinically healthy implants is uncertain.
Ethical Approval
Institutional Review Board statement: Not applicable.
Data Availability Statement
The data supporting this study's findings are available from the corresponding author upon reasonable request.
Authors' Contributions
M.A. and S.N.: conceptualization, writing manuscript, and methodology. H.K.K., A.S.: data extraction. A.B.M.R.A., M.N.: quality assessment.
Publication History
Article published online:
11 September 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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