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The effect of smoking on survival and bone loss of implants with a fluoride-modified surface: a 2-year retrospective analysis of 1106 implants placed in daily practice
Clinical Oral Implants Research, 05/11/2011
Clinical Article
Vervaeke S et al. – The present study is the first to compare peri–implant bone loss in smokers and nonsmokers from the time of implant insertion (baseline) to at least 2 years of follow–up. Implants with a fluoride–modified surface demonstrated a high survival rate and limited bone loss. However, smokers are at a higher risk of experiencing implant failure and more prone to show peri–implant bone loss in the maxilla.
Methods- Patient files of all patients referred for implant treatment from November 2004 to 2007 were scrutinized
- All implants were placed by the same experienced surgeon (B. C.)
- The only inclusion criterion was a follow–up time of at least 2 years
- Implant survival and bone loss were assessed by an external calibrated examiner (S. V.) comparing digital peri–apical radiographs taken during recall visits with the post–operative ones
- Implant success was determined according to the international success criteria (Albrektsson et al. 1986)
- Survival of implants installed in smokers and nonsmokers was compared using the log–rank test
- Both nonparametric tests and fixed model analysis were adopted to evaluate bone loss in smokers and nonsmokers
- One–thousand one–hundred and six implants in 300 patients (186 females; 114 males) with a mean follow–up of 31 months (SD 7.15; range 24–58) were included
- Nineteen implants in 17 patients failed, resulting in an overall survival rate of 98.3% at the implant level and 94.6% at the patient level
- After a follow–up period of 2 years, the cumulative survival rates was 96.7% and 99.1% with the patient and implant as the statistical unit, respectively
- Implant survival was significantly higher for nonsmokers compared with smokers (implant level P=0.025; patient level P=0.017)
- The overall mean bone loss was 0.34 mm (n=1076; SD 0.65; range 0–7.1)
- Smokers lost significantly more bone compared with nonsmokers in the maxilla (0.74 mm; SD 1.07 vs. 0.33 mm; SD 0.65; P<0.001), but not in the mandible (0.25 mm; SD 0.65 vs. 0.22 mm; SD 0.5; P=0.298)
