UI  - 97467690
TI  - Association between marginal bone loss around osseointegrated
      mandibular implants and smoking habits: a 10-year follow-up study.
AB  - While many factors are conceivable, occlusal loading and
      plaque-induced inflammation are frequently stated as the most
      important ones negatively affecting the prognosis of oral implants.
      Currently, little is known about the relative importance of such
      factors. The aim of this study was to analyze the influence of
      smoking and other possibly relevant factors on bone loss around
      mandibular implants. The participants were 45 edentulous patients, 21
      smokers and 24 non-smokers, who were followed for 10-year period
      after treatment with a fixed implant-supported prosthesis in the
      mandible. The peri-implant bone level was measured on intraoral
      radiographs, information about smoking habits was based on a careful
      interview, and oral hygiene was evaluated from clinical registration
      of plaque accumulation. Besides standard statistical methods,
      multiple linear regression models were constructed for estimation of
      the relative influence of some factors on peri-implant bone loss. The
      long-term results of the implant treatment were good, and only three
      implants (1%) were lost. The mean marginal bone loss around the
      mandibular implants was very small, about 1 mm for the entire 10-year
      period. It was greater in smokers than in non-smokers and correlated
      to the amount of cigarette consumption. Smokers with poor oral
      hygiene showed greater marginal bone loss around the mandibular
      implants than those with good oral hygiene. Oral hygiene did not
      significantly affect bone loss in non-smokers. Multivariate analyses
      showed that smoking was the most important factor among those
      analyzed for association with peri-implant bone loss. The separate
      models for smokers and non-smokers revealed that oral hygiene had a
      greater impact on peri-implant bone loss among smokers than among
      non-smokers. This study showed that smoking was the most important
      factor affecting the rate of peri-implant bone loss, and that oral
      hygiene also had an influence, especially in smokers, while other
      factors, e.g., those associated with occlusal loading, were of minor
      importance. These results indicate that smoking habits should be
      included in analyses of implant survival and peri-implant bone loss.