Comparative Evaluation of Root Coverage Between Smokers and Non-Smokers After Surgical Therapy-A Review and Meta-Analysis

Abstract

Background: Several studies have demonstrated that nicotine induces a pro-inflammatory effect due to the upregulation of receptors of the advanced glycation end product as well as the fibroblastic cell migration in the gingiva is reduced in smokers. Thus, this meta-analysis aims to evaluate and compare the effectiveness of root coverage after surgical therapy in smoker and non-smoker individuals. Methods: A total of 15 articles were included in this study in which the different types of periodontal surgical procedures for root coverage of gingival recession were evaluated in both smokers and non-smokers. The databases are searched from 1997 to 2018. The inclusion criteria included the available evidence and the articles published only in the English language. Result: In this meta-analysis, comparing smokers and non-smokers treated with different types of periodontal surgery, the result showed a statistically significant reduction in probing pocket depth (PPD), whereas, Gingival recession height (GRH), Gingival recession width (GRW) reduction and gain in clinical attachment level (CAL) and Keratinized tissue thickness (KTT) between smokers and non-smokers were not statistically significant. The percentage of complete and mean root coverage showed statistically significant variations when compared with smokers. Conclusion: Periodontal surgical interventions exhibited less favorable healing outcomes and there were significant variations observed in the percentage of mean and complete root coverage in smokers than compared with non-smoker.