Even When Lower Jaw Implants Stick, Smoking Can Cause Problems

Posted on January 16, 2017

Smoking causes a range of negative effects, particularly in the smoker’s mouth. The effects that smoking has on dental implants, however, is unclear. Even safe and effective treatments, such as dental implants, tend to fail more often in patients who smoke.

A study published in the current issue of the Journal of Oral Implantology focused on first-year success of dental implants in the lower jaw. If surgeons want to predictably know when and how to place implants in the mouths of heavy smokers, they need to understand how their patients’ habits will affect the healing process. Although research shows smoking can make implant and bone integration difficult in the upper jaw, few studies have considered the effects that this habit has on the lower jaw.

Researchers from The First Affiliated Hospital of Xi’an Jiaotong University in Xi’an, China studied how well bones healed and implanted tissue was accepted by heavy smokers who were missing some teeth at the back of their lower jaw. The researchers inserted dental implants for smokers and nonsmokers and restored the dental implants three months later, and then followed both groups for a year to find out whether heavy smoking had any ill effects. They were primarily interested in whether the dental implants would integrate with the bone and stay integrated once the implant was in function.

In both groups, implant stability decreased during the first two weeks after the implant surgery. In nonsmokers, stability began to improve and the implants began to form better connections (integration) to the bone after the second week. However, for heavy smokers, implants saw little change in the second week and only began to integrate into the lower jaw bone and become more stable after the third week following surgery.

Three months after surgery, heavy smokers’ implants had caught up and all patients had secure connections between bone and implant. Although all implants were considered successful, several months later the heavy smokers experienced more problems, including greater bone loss around the implants and larger soft-tissue pockets; however, smoking seemed to have little effect on plaque buildup and bleeding near the implants.

These researchers concluded that heavy smoking did not affect the overall success of the implant surgery, but that it did cause the bone around the implants to heal more slowly. Surgeons may need to change their standard implant schedule for patients who smoke heavily, and smokers may need to be aware that their habit could lead to other complications even after the implants are securely in place.

Full text of the article “Effect of Heavy Smoking on Dental Implants Placed in Male Patients Posterior Mandibles: A Prospective Clinical Study,” Journal of Oral Implantology, Vol. 42, No. 6, 2016, is now available at http://joionline.org/doi/full/10.1563/aaid-joi-D-16-00078.

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