Indian Journal of Dental Research

: 2019  |  Volume : 30  |  Issue : 1  |  Page : 3-

Effect of smoking on implant–bone interface

SM Balaji 
 Executive Editor, Indian Journal of Dental Research, Director and Consultant Oral and Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
S M Balaji
Executive Editor, Indian Journal of Dental Research, Director and Consultant Oral and Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu

How to cite this article:
Balaji S M. Effect of smoking on implant–bone interface.Indian J Dent Res 2019;30:3-3

How to cite this URL:
Balaji S M. Effect of smoking on implant–bone interface. Indian J Dent Res [serial online] 2019 [cited 2020 Sep 25 ];30:3-3
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Full Text

The negative impact of smoking tobacco on oral diseases and dental implant survival is well documented.[1] There has been cloudiness in the approach and the effect of tobacco on the oral tissues, especially on the implant–bone interface.[2]

Recent studies from private dental practices in Canada have identified that heavy tobacco smoking impacts marginal bone level, with time. The bone level is reported to reduce rapidly after 4 years. In this study, 2060 patients with 4591 implants were followed up for a mean of 32.2 ± 26.8 months with 29 heavy smokers.[3],[4]

On the contrary, recent research from Italy studied the long-term data (for about 8 years) on 384 implant survival and on the prevalence of peri-implantitis in a cohort of 77 patients, involving 96 jaw rehabilitations. The 10-year cumulative survival rate of implants was 96.11% in 84 implants whereas the cumulative rate of implants free from peri-implantitis was only 86.92% (95% confidence interval: 82.14%, 91.71%). Mandible implants had less peri-implantitis after 10 years, and this study identified that no correlation was found between periodontal and smoking status and outcomes.[5]

The contradicting results of the studies of long-term effect of smoking on dental implants are a cause of concern. Previous editorial in the same journal has pointed out the discrepancies in the evidence.[2] With the increasing use of dental implants, more clinicians look for evidence-based approach to the decision-making process.

The studies serve as grim reminder call for utilizing effective study designs and better measures and ruling out potential confounders including frequency, intensity, and pack years of tobacco use. Individual patient-based perspective of meta-analysis has to be studied further. The implant survival difference between private practice and the academic set up needs to be also explored.

The variety of tobacco forms in India poses a unique challenge and I believe that, in the near future, more works would be published about the gaps in the policies, protocols, and practices of dental implantology in India.


1Balaji SM. Tobacco smoking and surgical healing of oral tissues: A review. Indian J Dent Res 2008;19:344-8.
2Balaji SM. What is the evidence – Based relationship of peri-implantitis and smoking: A different perspective. Indian J Dent Res 2016;27:3.
3French D, Grandin HM, Ofec R. Retrospective cohort study of 4,591 dental implants: Analysis of risk indicators for bone loss and prevalence of peri-implant mucositis and peri-implantitis. J Periodontol 2019. doi: 10.1002/JPER.18-0236. [Epub ahead of print].
4French D, Larjava H, Ofec R. Retrospective cohort study of 4591 straumann implants in private practice setting, with up to 10-year follow-up. Part 1: Multivariate survival analysis. Clin Oral Implants Res 2015;26:1345-54.
5Francetti L, Cavalli N, Taschieri S, Corbella S. Ten years follow-up retrospective study on implant survival rates and prevalence of peri-implantitis in implant-supported full-arch rehabilitations. Clin Oral Implants Res 2019. doi: 10.1111/clr.13411. [Epub ahead of print].