Effect of smoking on early bone healing around oxidized surfaces: a prospective, controlled study in human jaws.
BACKGROUND
This prospective and controlled histologic study evaluates the impact of smoking on bone-to-implant contact, the bone density in the threaded area, and the bone density outside the threaded area around microimplants with anodized surface retrieved from human jaws.


METHODS
A total of 24 subjects (mean age 51.32 + or - 7.5 years) were divided in two groups: smokers (n = 13 subjects) and non-smokers (n = 11 subjects). Each subject received one microimplant with oxidized surface during conventional mandible or maxilla implant surgery. After 8 weeks, the microimplants and the surrounding tissue were removed and prepared for histomorphometric analysis.


RESULTS
Three microimplants placed in smokers showed no osseointegration. The newly formed bone showed early stages of maturation, mainly in the non-smokers. Marginal bone loss, gap, and fibrous tissue were present around implants retrieved from smokers. Histometric evaluation indicated that the mean bone-to-implant contact ranged between 25.97% + or - 9.02% and 40.01% + or - 12.98% for smokers and non-smokers, respectively (P <0.001). Smokers presented 28.17% + or - 10.32% of bone density in the threaded area, whereas non-smokers showed 46.34% + or - 19.12%. The mean of bone density outside the threaded area ranged between 18.76% and 25.11% for smokers and non-smokers, respectively (P >0.05).


CONCLUSIONS
The present data obtained in human subjects confirm that smoking has a detrimental effect on early bone tissue response around oxidized implant surfaces.
Shibli
Jamil Awad
JA
Department of Periodontology and Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil. jashibli@yahoo.com
Piattelli
Adriano
A
Iezzi
Giovanna
G
Cardoso
Luciana Ap
LA
Onuma
Tatiana
T
de Carvalho
Paulo Sérgio Perri
PS
Susana
d'Avila
d
Ferrari
Daniel S
DS
Mangano
Carlo
C
Zenóbio
Elton Gonçalves
EG
D016301:Alveolar Bone Loss / Q000209:etiology; D015519:Bone Density; D016022:Case-Control Studies; D020099:Coated Materials, Biocompatible; D015921:Dental Implants; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D016348:Osseointegration; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*; D013499:Surface Properties; D014025:Titanium
D020099:Coated Materials, Biocompatible; D015921:Dental Implants; C009495:titanium dioxide; D014025:Titanium