Association between smoking and Schneiderian membrane perforation during maxillary sinus floor augmentation: A systematic review and meta‐analysis

Abstract

Objective To estimate the association between smoking and Schneiderian membrane perforation in sinus floor augmentation. Materials and methods Searches were conducted in PubMed, Web of Science, Embase, and Cochrane Library. Data were extracted by two authors independently. The inclusion criteria were the (1) age of patients >18, (2) the number of participants >10, and (3) smoking and the patients of Schneiderian membrane perforation were accurately recorded. The risk of bias was assessed by the Newcastle–Ottawa scale (NOS). Statistics analyses were conducted using Reman5.4.1 and Stata (15.0). The association of Schneiderian membrane perforation with smoking habits during maxillary sinus floor elevation was expressed as odds ratios (ORs) with a 95% confidence interval (95% CIs). And the I2 statistic was used to estimate statistical heterogeneity. The funnel plot and Egger's tests were used to evaluate the reliability and stability of the results. Results Of 1463 articles screened, nine studies were included in our systematic review, and eight were synthesized for meta‐analysis. Eight were retrospective observational studies and one was a clinical trial, with a total of 1424 patients included. The nine studies were proved as high quality according to the NOS. There was no significant publication bias in the studies (p = 0.827). A random‐effects model was used because of differences in the adopted methodologies (p = 0.39, I2 = 5%). During maxillary sinus augmentation, smoking and Schneiderian membrane perforation were associated (odds ratios, 1.58 [95% CI, 1.10–2.25]). Conclusion Smoking increased the risk of membrane perforation in maxillary sinus floor augmentation. Our evaluation was limited by the poor reporting of the number of cigarettes smoked per day (PROSPERO number was CRD42022306570).

Survival analysis of implants placed simultaneously with lateral sinus floor elevation in severely atrophic maxilla: A 3‐ to 12‐year retrospective cohort study

“…Besides, another finding in this study was that smoking habit significantly jeopardized implant survival (HR: 6.055, p = 0.024). The adverse effect of tobacco smoking on implant survival and intraoperative complications in the LSFE technique has been demonstrated by several systematic reviews 38–41 . Smoking has been reported to increase the cytokines such as interleukin‐17 and induce inflammatory reactions, which leads to peri‐implantitis and marginal bone loss 39,42,43 .…”

“…Smoking has been reported to increase the cytokines such as interleukin‐17 and induce inflammatory reactions, which leads to peri‐implantitis and marginal bone loss 39,42,43 . Moreover, smoking could increase the risk of Schneiderian membrane perforation during the LSFE procedure and indirectly increase postoperative sinusitis and implant failure rates 41 …”

“…The adverse effect of tobacco smoking on implant survival and intraoperative complications in the LSFE technique has been demonstrated by several systematic reviews. [38][39][40][41] Smoking has been reported to increase the cytokines such as interleukin-17 and induce inflammatory reactions, which leads to periimplantitis and marginal bone loss. 39,42,43 Moreover, smoking could increase the risk of Schneiderian membrane perforation during the LSFE procedure and indirectly increase postoperative sinusitis and implant failure rates.…”

“…39,42,43 Moreover, smoking could increase the risk of Schneiderian membrane perforation during the LSFE procedure and indirectly increase postoperative sinusitis and implant failure rates. 41 Furthermore, this study comprehensively examined other possible risk factors of implant loss with simultaneous LSFE procedure, including patient characteristics, anatomical factors, surgical factors, and prosthetic factors.…”