A study reviewing the effect of cigarette smoking on the clinical outcomes of periodontal surgical procedures was published in the American Journal of the Medical Sciences. Databases were searched from 1968 to May 2010 using various combinations of the following key words: inflammation, mucoperiosteal flap, periodontal surgery, smoking, and tobacco. The inclusion criteria included all levels of available evidence. Articles published only in the English language were evaluated, and unpublished data were not sought. The study identified 24 clinical studies that met the criteria. The duration of smoking habit ranged from at least 5 years to 27.8 years. Sixteen studies showed that reductions in probing depth and gains in clinical attachment levels were compromised in smokers in comparison with nonsmokers. Three studies showed residual recession after periodontal surgical interventions to be significantly higher in smokers compared with nonsmokers. Three case reports showed periodontal healing to be uneventful in smokers. The authors conclude that, based on the studies reviewed, cigarette smoking has a negative effect on periodontal wound healing after surgical interventions.
