In a recent prospective study, researchers explored the impact of smoking on the survival rate of dental implants within 15 months after surgery, and the results showed that smoking has a significant adverse effect on implant success and surrounding bone tissue health.
Although smoking has been widely recognized as a risk factor for oral health and is associated with tooth loss and alveolar bone loss, there is still insufficient data on how continued heavy smoking affects peri-implant bone loss and implant survival.
Although previous studies have pointed out the link between smoking and implant failure, many studies lack prospective design and biochemical verification of smoking status.
In this study, the research team recruited a total of 29 patients with periodontal pocket depth of no more than 5 mm and one or more missing teeth.
Participants were divided into two groups based on smoking status: the smoking group (11 people) smoked more than 20 cigarettes a day for more than 5 years and were confirmed as nicotine users by urine cotinine testing; the non-smoking group (18 people) were lifelong non-smokers or had quit smoking for more than 5 years.
A total of 31 dental implants were implanted (13 in smokers and 18 in non-smokers) and followed up regularly for up to 67 weeks after surgery.
Key indicators such as marginal bone height, implant stability, periodontal pocket depth, bleeding on probing, and plaque index were evaluated at 15, 24, and 67 weeks after implantation.
The results showed that the implant survival rate in the smoking group was significantly lower than that in the non-smoking group (84.6% vs. 94.4%, P = 0.05), and the marginal bone loss in smokers was more than twice that of non-smokers at one year after surgery (1.5 ± 0.3 mm vs. 0.7 ± 0.6 mm, P = 0.0008). In addition, implant stability was slightly lower in smokers at 15 weeks (71.2 ± 3.5 vs. 73.8 ± 4.2, P = 0.031).
Although the periodontal pocket depth increased in both groups during the follow-up period, there was no statistically significant difference at 67 weeks.
It is worth noting that neither group experienced gingival atrophy, and the incidence of bleeding and suppuration on probing remained at a low level.
The researchers pointed out that the adverse effects of smoking may be related to the decreased healing ability of bone tissue and impaired immune function.
They emphasized that patients should be encouraged to quit smoking before dental implant surgery, especially heavy smokers, to improve the success rate of implants and reduce the risk of postoperative complications.
The research team called for further large-scale, long-term research aimed at developing intervention strategies based on evidence-based medicine to provide more effective preoperative guidance and postoperative management for smokers.