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. 2024 Feb 15;24(1):242.
doi: 10.1186/s12903-024-03989-1.

Does smoking cessation affect postoperative healing following oral surgery among smokers? - a systematic review

Magnus Olsson  1 , Eva Nordendahl  2   3   4 , Björn Klinge  2   5 , Anders Ekbom  3 , Christoffer Edlund  6 , Michael Fored  3 , Johan Sundström  7 , Aron Naimi-Akbar  2
Affiliations

Does smoking cessation affect postoperative healing following oral surgery among smokers? - a systematic review

Magnus Olsson et al. BMC Oral Health. .

Abstract

Background: It is well documented that smokers suffer increased risk of postoperative complications after medical surgery, for example delayed healing and increased risk of infection. It is also known that preoperative smoking cessation can reduce the risk of these complications. Because of this there are guidelines regarding preoperative smoking cessation in non-oral medical surgery. There are however no specific guidelines regarding oral surgical procedures, such as surgical extractions, dentoalveolar surgery, periodontal surgery, or dental implantation. Nevertheless, it is common that dentists and oral surgeons recommend smoking cessation pre to oral surgical procedures. The aim with this systematic review was to see if there are any evidence in the literature, supporting preoperative smoking cessation in oral surgical procedures.

Methods: A systematic search of the electronic databases PubMed, Scopus, Web of Science, and Cochrane was conducted to identify studies addressing the effect of preoperative smoking cessation in oral surgical procedures. Included publications were subjected to preidentified inclusion criterion. Six examiners performed the eligibility and quality assessment of relevant studies. Risk of bias was assessed using ROBINS-I and RoB 2. Certainty assessment was carried out using GRADE.

Results: The initial search resulted in 2255 records, and after removal of 148 duplicates, 16 articles met an acceptable level of relevance. These were read in full text, whereof 12 articles were excluded, due to different intervention, outcome, or study design than stated in the review protocol. One study remained with moderate risk of bias and three were excluded due to high risk of bias.

Conclusion: This systematic review could not determine the effect of smoking cessation pre to oral surgical procedures, in smokers. This indicates lack of knowledge in the effects of smoking cessation. We also conclude a lack of knowledge in how to design smoking cessation in the most effective way.

Keywords: Complication; Guideline; Healing; Oral surgery; Smoking cessation.

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Conflict of interest statement

JS is a shareholder of Anagram kommunikation AB and Symptoms Europe AB, outside the present study. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart
Fig. 2
Fig. 2
Methodological assessment of the remaining articles after full text assessment (n = 4) with the risk of bias in non-randomized studies of interventions (ROBINS-I) tool. One study was estimated to have a moderate risk of overall bias and was included. Three studies [–17] were removed without further review because the risk of confounding bias was considered critical
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