Tobacco smoking has been implicated in periodontal pathology through various mechanisms, including perturbations of the inflammatory and host responses to putative periodontal pathogens, alterations in the subgingival microbial communities, and a compromised healing potential of the tissues leading to imbalance of tissue homeostasis. This review provides the evidence for the relationship between cigarette smoking and periodontal disease in an attempt to explain possible mechanisms of how tobacco smoking may exert its negative effects on the periodontal tissues via systemic and localized pathways. Early and more recent studies explore cigarette smoking–induced changes in periodontal clinical indices; in subgingival microbial flora by employing traditional detection methods for selected microorganisms, in addition to modern techniques such as deep sequencing and bioinformatics analyses that are able to fully characterize the microbial communities; and in inflammatory and immune responses critically appraising study limitations and differences in study protocol designs. Periodontal treatment outcomes and implant therapy outcomes are reviewed in an attempt to shed light on possible mechanisms for the inferior treatment outcome noted in smokers. The potential harmful effects of passive smoking are also reviewed, providing evidence for the advantages of smoking cessation. Quitting cigarette smoking should be recommended by the dentist, and effort should be made to inform smokers about the negative effects of smoking on the periodontal status and implant therapy outcomes.

中文翻译：

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吸烟在牙周病中的作用和种植牙治疗的疗效

吸烟通过多种机制与牙周病理学有关，包括对假定牙周病原体的炎症和宿主反应的扰动、龈下微生物群落的改变以及导致组织稳态失衡的组织愈合潜力受损。本综述为吸烟与牙周病之间的关系提供了证据，试图解释吸烟如何通过全身和局部途径对牙周组织产生负面影响的可能机制。早期和最近的研究探讨了吸烟引起的牙周临床指标变化；通过对选定微生物采用传统检测方法，在龈下微生物群落中，除了能够充分表征微生物群落的现代技术，如深度测序和生物信息学分析；在炎症和免疫反应中，批判性地评估研究限制和研究方案设计的差异。对牙周治疗结果和种植体治疗结果进行了审查，以试图阐明吸烟者所注意到的较差治疗结果的可能机制。还回顾了被动吸烟的潜在有害影响，为戒烟的优势提供了证据。牙医应建议戒烟，并应努力告知吸烟者吸烟对牙周状况和种植治疗结果的负面影响。