Smoking and its Impact on Orthodontic Treatment/Management  Modalities: A Systematic Review and Meta-Analysis

Mohammad Khursheed  Alam; Haifa Ali  Almutairi; Rowida Saleh  Barayan; Huda Abutayyem; Haytham Jamil  Alswairki; Ahmed Ali  Alfawzan; Mohammad Younis  Hajeer; Ahmed Saleh  Albalawi; Khalid Hussain Ali  Alruwaili; Rakhi Issrani; Namdeo  Prabhu

doi:10.18502/ijph.v53i8.16276

Mohammad Khursheed Alam Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
Haifa Ali Almutairi College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
Rowida Saleh Barayan Ministry of Health, Badanah Primary Healthcare, Badanah, Kingdom of Saudi Arabia
Huda Abutayyem Department of Clinical Sciences, Center of Medical and Bio-Allied Health Sciences Research, College of Dentistry, Ajman University, Ajman, United Arab Emirates
Haytham Jamil Alswairki School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
Ahmed Ali Alfawzan Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Kingdom of Saudi Arabia
Mohammad Younis Hajeer Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, Syria
Ahmed Saleh Albalawi College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
Khalid Hussain Ali Alruwaili College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
Rakhi Issrani Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
Namdeo Prabhu Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia

DOI: https://doi.org/10.18502/ijph.v53i8.16276

Keywords: Cigarette smoking; Miniscrews; Orthodontics; Orthodontic appliances; Orthodontic wires

Abstract

Background: We aimed to review studies that evaluated the effect of cigarette smoking on orthodontic treatment methods and determine whether the smoke affected appliances in a way that could impair the effectiveness of the overall treatment strategy.

Methods: PubMed, Google Scholar, Cochrane Library, and Web of Science were scoured using pertinent keywords, reference searches, and citation searches in accordance with the PRISMA protocol regarding articles published from 2008 till 2022.

Results: Ultimately, 7 papers were chosen for further analysis at the end of the selection protocol. Overall pooled odds ratio (OR) for the impact of cigarette smoking on orthodontic treatment was 0.25 (95% CI: 0.15, 0.43), with high statistical significance (P<0.00001) but also high heterogeneity (I² = 81%). The relative risk (RR) was 0.50 (95% CI: 0.38, 0.66), indicating a 50% greater risk of noticeable impact, with high statistical significance (P<0.00001) and high heterogeneity (I² = 79%), and the risk difference (RD), which was -0.33 (95% CI: -0.45, -0.21), suggesting a 33% higher risk of noticeable impact, with high statistical significance (P<0.00001) and high heterogeneity (I² = 81%). The high heterogeneity in all measures indicates significant variability in the results across the included studies.

Conclusion: All the 7 studies selected for our systematic review exhibited significant detrimental associations between smoking and orthodontic appliances and other modalities that were exposed to cigarette smoke. However, more studies need to be done in this regard, since the literature currently available on this relationship is quite poor and lacking in concrete evidence.