The Influence of Tobacco on Early Dental Implant Failure

Effect of smoking on the survival of dental implants

“…The nitrosamines, aldehydes, carbon monoxide, carbon dioxide, ammonia and benzene are components of the cigarette that may affect the bone healing process. Carbon monoxide is a competitor/inhibitor of the oxygen and decreases the oxygen carrying capacity of red blood cells; the hydrogen cyanide promotes hypoxia by inhibiting the enzyme systems necessary for metabolism oxidation 7,13,15,17,21,31 . Additionally, smoking is associated to the increased concentration of reactive oxygen and reduced levels of vitamins 32 .…”

“…The first is related to the surgical technique, implant type and place, waiting time between tooth extraction and implant insertion, and between implant insertion and loading. The second consists in patient characteristics such as uncontrolled diabetes, alcohol consumption and smoking 7 . In the oral cavity, the smoking habit is associated with delayed bone healing, reduced bone height, increased rate of bone loss, formation of poor quality bone as well as increased incidence of peri-implantites [8][9][10][11][12][13][14] .…”

“…Smokers present 1.69 times higher chances of implant failures than non-smokers during the first implant surgical stage (before prosthesis insertion). The smoking habit has also been associated with delayed failures of dental implants such as those occurring during the second implant surgical stage 6,7 . Additionally, a multivariate survival analysis showed that short implants and implant placement in the maxilla were additional independent risk factors for implant failure 6 .…”

“…Failures generally occur due to the deposition of fibrous tissue at the bone-implant interface 7 . The implant insertion may be compared to the healing process after bone fracture.…”

“…Depending on the local conditions, and the presence of relative immobility of the implant, pluripotent mesenchymal cells differentiate into osteoblasts and fibroblasts, and a healing and bone tissues are formed. The presence of cigarette components affects this process 7 . For this reason, as the use of dental implants to rehabilitate edentulous patients has become widespread and the use of cigarettes is considered one of the main factors in implant failures, it is essential to understand the role of smoking on the peri-implant bone healing.…”