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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\u2013induced 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.<\/jats:p>","DOI":"10.1111\/prd.12449","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T07:44:18Z","timestamp":1660203858000},"page":"45-61","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":136,"title":["The role of cigarette smoking in periodontal disease and treatment outcomes of dental implant therapy"],"prefix":"10.1111","volume":"90","author":[{"given":"Danae Anastasia","family":"Apatzidou","sequence":"first","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTh)  Thessaloniki 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