Influence of smoking upon dental implant osseointegration: a radiofrequency analysis of 194 implants

While many studies have related smoking to periimplantitis and marginal bone loss, little is known of its potential impact upon dental implant osseointegration. The present clinical study explores the influence of smoking upon secondary stabilization based on radiofrequency analysis. A total of 194 implants in 114 patients were included. Implant stability was evaluated on the day of surgery and a minimum of 90 days after implantation, when osseointegration is considered to have been completed. The evolution of implant stability was compared between two groups: smokers versus non-smokers. The following variables were also analyzed: implant brand, model, length and diameter, insertion torque, bone density according to the Misch classification, location of the implant, and patient age and gender. The results showed that smoking does not affect primary stability of the implant, though it was associated to a marked decrease in secondary stability. The non-smokers showed a gain of 2.69 points (95%CI: 1.529 to 3.865) in the osseointegration process with respect to the smokers (p<0.001). Among the latter, implant stability was seen to decrease 0.91 points (95%CI: -3.424 to 1.600) (p<0.004), generating a difference of 3.61 points between smokers and non-smokers. 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; Smoking; osseointegration; resonance frequency analysis.