Influence of Smoking on Dental Implant Osseointegration: A Radiofrequency Analysis of 194 Implants

J Oral Implantol. 2021 Apr 1;47(2):110-117. doi: 10.1563/aaid-joi-D-19-00223.


Although many studies have related smoking to peri-implantitis and marginal bone loss, little is known of its potential impact on dental implant osseointegration. The present clinical study explores the influence of smoking on secondary stabilization based in radiofrequency analysis. A total of 194 implants in 114 patients were included. Implant stability was evaluated on the day of surgery and at a minimum of 90 days after implantation, when osseointegration is considered to have been completed. The evolution of implant stability was compared between 2 groups: smokers and nonsmokers. The following variables were also analyzed: implant brand and model, length, diameter, insertion torque, bone density according to the Misch classification, location of the implant, and patient age and gender. The results showed that smoking did not affect the primary stability of the implant, although it was associated with a marked decrease in secondary stability. The nonsmokers showed a gain of 2.69 points (95% confidence interval [CI]: 1.529-3.865; P < .001) in the osseointegration process. However, in the smokers group, implant stability was seen to decrease 0.91 points (95% CI: -3.424 to 1.600; P < .004), generating a difference of 3.61 points between smokers and nonsmokers. Smoking is thus concluded to be an important factor that must be taken into account when seeking good implant osseointegration outcomes.

Keywords: bone–implant interface; endosseous dental implantation; nicotine; osseointegration; radiofrequency analysis; smoking.

MeSH terms

  • Dental Implantation, Endosseous
  • Dental Implants*
  • Humans
  • Osseointegration
  • Peri-Implantitis*
  • Smoking
  • Torque


  • Dental Implants