Dental News - Research: Implant treatment plan should be adapted for smokers

Dental Tribune USA

Fri. 17 February 2017

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A Chinese study comparing implant stability and peri-implant tissue response in heavy smokers and non-smokers has found that smoking did not affect the overall success of implant surgery, as all implants achieved osseointegration without complications at least by the end of the 12th week after placement. However, smoking did cause the bone around the implants to heal more slowly; thus, implants began to osseointegrate considerably later than in the non-smoking group.

Research has demonstrated that smoking can negatively affect implant and bone integration. In order to improve treatment outcomes and avoid implant failure, surgeons need to have a precise understanding of how the habit will affect the healing process.

In the current study, 45 ITI (Straumann) implants were placed in the partially edentulous posterior mandibles of 32 male patients, including 16 who were heavy smokers and 16 who did not smoke at all. Implant stability and peri-implant tissue response were assessed at three, four, six, eight and 12 weeks post-surgery.

Although implants in both groups achieved osseointegration by the end of the 12th week, the healing process differed significantly between non-smokers and heavy smokers. In non-smokers, stability improved and implants began to better integrate into the bone after the second week.

In the smoking group, however, implants only began to osseointegrate and become more stable after the third week.
Despite successful short-term outcomes in both groups, smokers experienced more problems, including greater bone loss around the implants and deeper soft-tissue pockets. However, smoking had no significant effect on plaque build-up or sulcular bleeding in the study group.

In light of the findings, the researchers suggested that surgeons might need to change their standard implant loading schedule for patients who smoke heavily.

In addition, smokers should be aware that their habit promotes the loss of marginal bone and the further development of dental pockets and could thereby lead to complications even after osseointegration, the researchers concluded.

The report, titled “Effect of heavy smoking on dental implants placed in male patients posterior mandibles: A prospective clinical study,” was conducted by researchers at the First Affiliated Hospital of Xi’an Jiaotong University in Xi’an in China. The results were published in the December 2016 issue of the Journal of Oral Implantology.

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