Smoking & peri-implantitis

Tobacco use is an undisputed risk factor for periodontitis – in terms of development and progression of the disease, the patient’s treatment response as well as in the maintenance phase (see the article: Smoking & periodontitis sowie Smoking affects the maintenance phase).

But does tobacco use also affect the peri-implant tissues? Do smokers with implants suffer from problems with peri-implantitis more often than non-smokers do? What data are available?

In general, there are far fewer studies about smoking and peri-implantitis than there are about smoking and periodontitis, but a recently published review (Casado et al. 2019) has summarized the literature available. The following conclusions can be drawn from this review of 19 studies:

The mechanisms that account for why smoking is a risk factor for peri-implantitis are similar to those for periodontitis. Tobacco smoke contains more than 4000 substances. Of these, about 250 are poisonous and almost 100 are carcinogenic. Among other things, these substances (e.g. nitrosamines, nicotine, carbon dioxide, carbon monoxide etc.) reduce the blood flow of the peri-implant tissues, and weaken the immune system and the activity of the bone-forming osteoblasts.

Stopping smoking at the time of implantation could possibly reduce the risk of peri-implantitis and subsequent implant loss; however, there are very few studies on this topic to be able to scientifically prove this (Lambert et al. 2000).

In general, it should of course be taken into account that the development of peri-implantitis is a multifactorial process; i.e., smoking will very likely increase a patient’s risk of developing peri-implantitis, but not all smokers with implants will necessarily get peri-implantitis.

The following link about smoking is worth a visit:https://www.rauch-frei.info

Reference

1. Casado PL, Aguiar T, Fernandes Pinheiro MP, Machado A, da Rosa Pinheiro A. Smoking as a Risk Factor for the Development of Periimplant Diseases. Implant Dent. 2019 Apr; 28(2):120-124. doi: 10.1097/ID.0000000000000876. Lambert PM, Morris HF, Ochi S. The influence of smoking on 3-year clinical success of osseointegrated dental implants. Ann Periodontol. 2000 Dec;5(1):79-89.