Impact of heavy smoking on the clinical, microbiological and immunological parameters of patients with dental implants: a prospective cross-sectional study

J Investig Clin Dent. 2016 Nov;7(4):401-409. doi: 10.1111/jicd.12176. Epub 2015 Jul 14.


Aim: The aim of the present study was to investigate how heavy smoking influences the clinical, microbiological, and host-response characteristics in peri-implant sulcus fluid of patients with healthy dental implants.

Methods: A total of 29 individuals with 74 dental implants were included in the present study; 20 implants were in heavy smokers and 54 were in non-smokers. The modified gingival index, modified plaque index, and probing pocket depth were evaluated. Periodontopathogenic bacteria Tannerella forsythia, Treponema denticola, and Porphyromonas gingivalis were evaluated, together with the total bacterial load. Peri-implant sulcus fluid samples were analyzed for the quantification of interleukin-8, interleukin-1β, interleukin-6, interleukin-10, and tumor necrosis factor-α.

Results: No significant differences in the clinical parameters evaluated were found between the groups, although smokers had poorer peri-implant parameters. Among the smokers, subgingival microbiota was composed of a greater number of periodontal pathogens; these differences were not statistically significant. Smokers showed a greater expression of interleukin-1β, interleukin-6, interleukin-10, and tumor necrosis factor-α, but interleukin-8 was slightly higher among non-smokers, but not significantly.

Conclusions: Although smokers presented deeper probing depths, bleeding on probing, and peri-implant microbiota composed of a greater number of periodontal pathogens than in non-smoking patients, these data did not show significant differences. In the present study, and in relation to the samples analyzed, smoking alone did not influence the immunological and microbiological parameters in dental implants with healthy peri-implant tissues. Further studies with larger samples are required to better evaluate the influence of smoking on dental implants.

Keywords: cytokine; dental implant; periodontal pathogen; smoking; tobacco.

MeSH terms

  • Aged
  • Bacterial Load
  • Cross-Sectional Studies
  • Cytokines / analysis
  • Dental Implants* / microbiology
  • Dental Plaque Index
  • Dental Prosthesis, Implant-Supported*
  • Female
  • Gingival Crevicular Fluid / immunology
  • Gingival Crevicular Fluid / microbiology
  • Humans
  • Interleukin-10 / analysis
  • Interleukin-1beta / analysis
  • Interleukin-6 / analysis
  • Interleukin-8 / analysis
  • Male
  • Middle Aged
  • Peri-Implantitis / immunology*
  • Peri-Implantitis / microbiology*
  • Periodontal Index
  • Periodontal Pocket / immunology
  • Periodontal Pocket / microbiology
  • Porphyromonas gingivalis / isolation & purification
  • Prospective Studies
  • Smoking / adverse effects*
  • Spain
  • Tannerella forsythia / isolation & purification
  • Treponema denticola / isolation & purification
  • Tumor Necrosis Factor-alpha / analysis


  • CXCL8 protein, human
  • Cytokines
  • Dental Implants
  • IL10 protein, human
  • IL6 protein, human
  • Interleukin-1beta
  • Interleukin-6
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • Interleukin-10