Retrospective Evaluation of the Effects of Cigarettes on Dental Implants

Objectives: The use of dental implants has been integral to restorative dentistry, however, the incidence for implant loss with a follow-up period of at least 10 years has ranged from 1% to 18% [1]. This study investigates whether smoking is related to rates of implant failure at 5-year and 10-year intervals.
Methods: 250 electronic patient records were evaluated regarding individual implants placed at Tufts University School of Dental Medicine from August 1, 2004 to March 31, 2015. Each implant record was evaluated to determine if the implant was successful, had failed, or was failing. Successful implants were defined as implants in function as seen on the most recent radiograph and have lost <2mm of bone support following placement and restoration. Failed implants were defined as any implant which is no longer in the mouth post placement. Implants which are failing were defined as implants that have lost >2mm of bone following placement. To assess this, bone levels from the implant platform to the most apical level of bone at the site of the implant were recorded at the date of placement, at the final restoration placement date, and at the most recent clinical visit. Once data was obtained to include a sample of n=50 smokers and n=50 non-smokers, the percentage of failed, failing, and successful implants were calculated for each group.
Results: Of the 50 subjects of the non-smoker group, 4 (8%) subjects had peri-implantitis (failing) and 1 (2%) subject had a failed implant. Of the 50 subjects in the smokers group, 32 (64%) subjects had peri-implantitis and 7 (14%) subjects had failed implants.
Conclusions: Our data suggests subjects with implants who smoke are more subject to having failed or “failing” implants than non-smokers. The results of this pilot study were used to calculate sample size needed for further investigation in a larger and more comprehensive study with multiple variables.