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Tobacco Use & Endosseous Implant Failures

The health effects of tobacco use can be summarized as following:

  • Nicotine exhibit a profound vasoconstrictor effect on blood vessels, causing disrupting the healing processes of hard and soft tissues.
  • It increases palatal adhesiveness, which in turn causes thrombotic microvascular occlusion with resulting ischemia, and reduces the proliferation of blood cells, firbroblast and macrophages.
  • Carbon monoxide and hydrogen cyanide decreases the oxygen available, and hence slow healing.
  • Smokers have a higher incidence and greater severity of periodontal / peri-implantitis. Though information is limited on implants and smoking.
  • Bain and Moy found that 590 implants placed in smokers, 11% failed compared with 4.8% in non-smokers.
  • De Bruyn & Collaert found 31% early implant failures in fixtures placed in the maxilla in smokers.
  • Tobacco may reduce the capacity of bone to repair during the healing period.
  • Continued use of tobacco reduces the ability of the bone to repair damage that occurs during clinical use.
  • The deleterious effects of smoking can be minimized if smoking stopped for four weeks.
  • HA-coated implants have advantage over other in smokers.
  • Preoperative antibiotic use reduces failure.