Peri‐implant soft tissue status and crestal bone loss around immediately‐loaded narrow‐diameter implants placed in cigarette‐smokers: 6‐year follow‐up results

Abstract

Background It is hypothesized that in the long‐term, soft tissue inflammation (reflected by increased scores of peri‐implant probing‐depth [PD]) and crestal bone loss (CBL) is higher in cigarette‐smoker than nonsmokers with narrow diameter implants (NDIs). Purpose The aim of the present 6‐years' follow‐up clinical observational study was to compare the peri‐implant soft tissue inflammatory parameters (plaque index [PI], gingival index [GI], and PD) and CBL around immediately‐loaded NDIs placed in cigarette‐smokers and nonsmokers. Materials and methods In all groups, peri‐implant GI, PI and PD were measured on six sites (distolingual/palatal, mesiolingual/palatal mesiobuccal, distobuccal, midlingual/palatal, and midbuccal) per implant. The CBL was gauged on digital bitewing x‐rays, which were standardized using the long cone paralleling technique. CBL was demarcated as the vertical distance from 2 mm below the implant‐abutment connection to the most crestally‐positioned alveolar bone. Results All study‐participants were male. Twenty‐six cigarette smokers and twenty‐five nonsmokers were included. The mean age of cigarette‐smokers and nonsmokers was 45.5 ± 10.3 and 47.4 ± 9.4 years, respectively. Cigarette‐smokers had a smoking history of 10.6 ± 0.4 pack years. Family history of tobacco usage was more often reported by cigarette‐smokers (57.7%) than nonsmokers (20%). All cigarette‐smokers and nonsmokers were aware that smoking is a risk‐factor of loss of implant. Three (11.5%) of cigarette‐smokers reported that they have attempted to quit smoking and 76.9% of cigarette‐smokers (n = 20) reported that they had no intention to quit smoking in the future. The peri‐implant P‐I (P < .01), PD (P < .01) and mesial (P < .01), and distal (P < .01) CBL were significantly high in cigarette‐smokers compared with nonsmokers. There was no statistically significant difference in GI among the groups. Conclusion Cigarette‐smoking enhances peri‐implant soft tissue inflammation and increases CBL around immediately‐loaded NDIs.

Assessment of advanced glycation end products in the peri‐implant sulcular fluid among moderate cigarette‐smokers and nonsmokers with peri‐implantitis

“…31,32 In all radiographs, marginal bone loss (MBL) was gauged as the vertical distance from 2 mm below the implantabutment-junction to the osseous crestal. 13,33…”

“…13 These measurements were done on the distolingual/palatal, mesiolingual/palatal, mesiobuccal, distobuccal, midlingual/palatal, and midbuccal surfaces per implant. 13 Radiography-based investigations were carried out by TA (kappa score 0.9) using the long cone paralleling technique. 31,32 In all radiographs, marginal bone loss (MBL) was gauged as the vertical distance from 2 mm below the implantabutment-junction to the osseous crestal.…”

“…[13][14][15][16] Besides poor oral hygiene, habitual tobacco-smoking in the form of cigarettes and waterpipe-tobacco are well-renowned risk factor of peri-implant diseases. 13,[17][18][19][20][21][22] According to ArRejaie et al 18 levels of destructive inflammatory cytokines (matrix-metallo-proteinase-9 and IL-1beta) are significantly higher in the peri-implant sulcular fluid (PISF) of cigarette-smokers compared with never-smokers (patients that never used tobacco in any form). These cytokines have been reported to contribute towards worsening the peri-implant soft tissue plaque index (PI), gingival index (GI), and probing depth; and increasing crestal bone loss (CBL) on the mesial and distal surfaces of the implant.…”

“…A dilemma in clinical implant dentistry and related research is the prevention and treatment of dental implant‐related diseases 13‐16 . Besides poor oral hygiene, habitual tobacco‐smoking in the form of cigarettes and waterpipe‐tobacco are well‐renowned risk factor of peri‐implant diseases 13,17‐22 .…”

“…A dilemma in clinical implant dentistry and related research is the prevention and treatment of dental implant‐related diseases 13‐16 . Besides poor oral hygiene, habitual tobacco‐smoking in the form of cigarettes and waterpipe‐tobacco are well‐renowned risk factor of peri‐implant diseases 13,17‐22 . According to ArRejaie et al 18 levels of destructive inflammatory cytokines (matrix‐metallo‐proteinase‐9 and IL‐1beta) are significantly higher in the peri‐implant sulcular fluid (PISF) of cigarette‐smokers compared with never‐smokers (patients that never used tobacco in any form).…”