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08-08-2011 | Article

Smoking increases postoperative complications in patients with dental implants


Free abstract

MedWire News: Patients with dental implants who smoke are at greater risk of postoperative complications compared with patients who do not smoke, research published in the Journal of Oral and Maxillofacial Surgery suggests.

The treatment success rates of osseointegrated dental implants of different implant systems is approximately 90%.

Implant loss, infection and inflammation of the peri-implant mucosa, with or without bone loss are common complications of implant treatment. Each of these complications is associated with a number of risk factors that can be separated into implant- (including surgical procedure, implant surface type and loading protocol) and patient-related (hygiene, diabetes, alcohol abuse, and smoking) risk factors.

However, while smoking is known to be a risk factor for implant failure, it is not clear what effect it has on the relevant associated risk factors.

In the present retrospective study, Eduard Valmaseda-Castellón (University of Barcelona, Spain) and colleagues examined the impact of smoking on the risk factors associated with complications following implant surgery.

A total of 295 patients were included in the study (43% men, mean age 53 years). These patients received 1033 implants in total, and experienced 209 complications. Of the patients enrolled in the study, 38% were smokers. Analysis showed that smokers had a significantly increased risk of complications compared with non-smokers: implant loss, 3.6% versus 2.8%; peri-implantitis, 9.3% versus 5.3%; mucositis, 11.8% versus 9.2%; and postoperative infection, 0.5% versus 0.0%.

Men had a greater risk of complications than women, but as the authors point out, this could be a result of a significantly higher prevalence of smoking among men than women.

There was no significant effect of implant location (molar, incisor, canine, bicuspid) on complication rates, but implants in the maxilla were less likely to be free from complications compared with those in the mandible (76.8% vs 82.9%).

With regards to implant characteristics, wider or longer implants were more prone to loss of osseointegration, and thinner or shorter implants were more prone to infection.

In conclusion, the authors note: "Smokers had an increased risk of complications...compared with nonsmoking patients. Although implant therapy can be applied to smokers, these patients should be encouraged to cease this habit or decrease its intensity, otherwise complications could occur."

By Iain Bartlett