The effect of cigarette smoking on early osseointegration of dental implants: a prospective controlled study

Clin Oral Implants Res. 2016 Sep;27(9):1123-8. doi: 10.1111/clr.12705. Epub 2015 Sep 26.


Objective: This study evaluated the effect of cigarette smoking on the percentage of early bone-to-implant contact (BIC%), the bone density in the threaded area (BA%) as well as the bone density outside the threaded area (BD%) around micro-implants with sandblasted acid-etched surface retrieved from human jaws.

Material and methods: Twenty-two subjects (mean age 55.4 ± 4.5 years) were divided in two groups: smokers (n = 11 subjects) and never-smokers (n = 11 subjects). Each subject received one micro-implant during conventional mandible or maxilla implant surgery. After 8 weeks, the micro-implants and the surrounding tissue were removed and prepared for histomorphometric analysis.

Results: Two micro-implants placed in smokers showed no osseointegration. Early stages of maturation of the newly formed bone were present, mainly in the never-smokers. Marginal bone loss, gap, and fibrous tissue were present around some implants retrieved from smokers. Histometric evaluation indicated that the mean BIC% ranged between 25.9 ± 9.1 and 39.8 ± 14.2 for smokers and non-smokers, respectively (P = 0.02). Smokers presented 28.6 ± 10.1 of BA% while never-smokers showed 46.4 ± 18.8 (P = 0.04). The mean of BD% ranged between 19.1 ± 7.6 and 28.5 ± 18.8 for smokers and never-smokers, respectively (P = 0.21).

Conclusion: Cigarette smoking has a detrimental effect on early bone tissue response around sandblasted acid-etched implant surface topographies.

Keywords: Implant surface topography; dental implants; human histology; osseointegration; smoking; wound healing.

MeSH terms

  • Alveolar Process / drug effects
  • Alveolar Process / pathology
  • Bone Density
  • Dental Implantation, Endosseous*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osseointegration* / drug effects
  • Prospective Studies
  • Smoking / adverse effects*