Tobacco as a risk factor for survival of dental implants

J Periodontol. 2007 Feb;78(2):351-9. doi: 10.1902/jop.2007.060299.


Background: It has been shown that smoking habits represent an increased risk for impaired bone healing and implant failure. This study aimed to evaluate the implant survival rates among non-smokers (NS) and different kinds of smokers (S).

Methods: A retrospective analysis was made over a 5-year period of the clinical and radiographic findings corresponding to 66 consecutive patients who had received a total of 165 dental implants. Patients were divided into two groups: S, 40 patients (95 implants; 58% of the sample); and NS, 26 patients (70 implants; 42% of the sample). Also, S and NS were classified into four different categories according to daily tobacco use: NS, 26 patients and 70 implants; light smokers (LS), 23 patients and 44 implants; moderate smokers (MS), 11 patients and 25 implants; and heavy smokers (HS), six patients and 26 implants.

Results: Sixteen implants (9.7%) failed and had to be removed. Group S showed 15 failures and a success rate of 84.2%. Group NS had only one failure, giving a success rate of 98.6%. The risk of implant failure was approximately 31% in those who smoked more than 20 cigarettes per day. HS showed statistical differences from NS or LS. However, they did not show any differences from MS.

Conclusions: Within the limits of the present study, the use of tobacco involves a 15.8% risk of implant failure, with a 13.1 odds ratio. LS or MS tobacco use involves a 10.1% relative risk of implant loss, whereas the consumption of >20 cigarettes per day increases this risk to 30.8%.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Bone Density
  • Dental Implantation, Endosseous
  • Dental Implants*
  • Dental Prosthesis Retention
  • Dental Prosthesis, Implant-Supported
  • Dental Restoration Failure*
  • Humans
  • Middle Aged
  • Nicotiana / adverse effects*
  • Odds Ratio
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects*


  • Dental Implants