In a new study, researchers have examined the effects of smoking on the survival of dental implants over 15 months postplacement.
Although a history of smoking is known to adversely affect oral health—leading to tooth loss and alveolar bone loss—there is currently limited data on how sustained, heavy smoking might influence peri-implant bone loss and implant longevity. Previous studies have suggested a relationship between smoking status and dental implant failure, but many lacked prospective data or biochemical confirmation of smoking status.
In this prospective cohort study, researchers recruited 29 patients with pocket depths of ≤ 5 mm and one or more missing teeth, dividing them into two groups based on smoking status. The smoking group consisted of 11 participants who reported smoking over 20 cigarettes per day for more than 5 years and tested positive for nicotine use via urine cotinine assay. The nonsmoking group included 18 lifelong nonsmokers or individuals who had quit more than 5 years prior. A total of 31 implants were placed (13 in smokers and 18 in nonsmokers), and the participants were followed for up to 67 weeks postimplantation.
Cinical and radiographic assessments were conducted at baseline and at 15, 24, and 67 weeks postplacemenet. The researchers measured factors such as marginal bone height, peri-implant pocket depth, implant stability, bleeding on probing, and plaque index.
Compared with nonsmokers, smokers demonstrated a lower rate of implant survival (84.6% vs 94.4%, P = .05) and more than double the amount of marginal bone loss (1.5 ± 0.3 mm vs 0.7 ± 0.6 mm, P = .0008) 1 year postloading. Implant stability was also slightly lower in smokers at the 15-week mark (71.2 ± 3.5 vs 73.8 ± 4.2, P = .031). While pocket depth increased in both groups over time, no statistically significant differences were observed between smokers and nonsmokers at the67-week follow-up.
No gingival recession was noted in either group, and rates of bleeding on probing and suppuration were low across the board. The researchers suggested that the negative effects observed in the smoking group may be the result of impaired bone healing and immune function.
Given these findings, the researchers emphasized the importance of recommending smoking cessation prior to dental implant surgery, noting that long-term tobacco use—especially at heavy levels—may compromise implant success. They called for further research to develop evidence-based interventions that reduce risk in this high-risk population.
Source: Journal of Periodontology
