Methods: A total of 480 young adults who arrived at a military dental clinic for dental screening prior to their military service were included in the study. Anamnesis included information regarding smoking habits (amount and duration). All participants underwent bilateral standardized posterior bitewing radiographs using the same digital X-ray equipment and the same radiation parameters. The mesial aspect of all first molars was evaluated for bone height, measured from the cemento-enamel-junction (CEJ) to the bone crest, and bone density using computer-assisted densitometric image analysis. The software calculated the average gray intensity as a value between 0 and 255, which reflects the radiographic bone density.
Results: The study consisted of 480 participants with a mean age of 19.12±1 years (range 18-29); all of them were males. Overall, 108 (22.5%) were current smokers and 372 (77.5%) non smokers.
Smokers exhibited significantly lower bone density values than non-smokers (94.81 vs. 103.41 respectively; p<0.002). Bone measurements indicated a significantly higher distance from the CEJ to the alveolar bone crest among smokers (1.57mm vs. 0.95 mm; p<0.001). This distance was positively correlated to the reported number of cigarettes smoked per day and number of smoking years (p<0.001).
Bone density in the maxilla was found to be higher than in the mandible (108.09 vs. 95.53 respectively; p<0.001) and higher distance from the CEJ to the alveolar bone crest was fond in the mandible (1.23 vs. 0.91; p<0.001).
Conclusions: Smoking produces an adverse effect on alveolar bone height and density, acting as a potential risk factor for alveolar bone loss, even at an early age with low tobacco consumption. It is very important to inform young smokers about the risk of this habit in relation to periodontal health.