title: A prospective cohort study on the impact of smoking on soft tissue alterations around single implants.
abstract: OBJECTIVE
  To compare smokers to non-smokers in terms of soft tissue alterations following single implant treatment in healed bone.
  
  
  METHODS
  Non-smoking and smoking patients with sufficient bone volume in need of a single implant in the anterior maxilla (15-25) were consecutively recruited in three centres. Conventional single implant surgery was performed and an immediate provisional crown was installed. Eight to 12 weeks later, the latter was replaced by a permanent one (baseline). Papilla regrowth and midfacial recession was registered after 2 years of function.
  
  
  RESULTS
  The sample consisted of 39 non-smokers (21 females; mean age 42) and 46 smokers (22 females; mean age 45). Smokers had three early failures, whereas all implants integrated successfully in non-smokers. Statistically significant papilla regrowth was observed in non-smokers (distal 0.63 mm, mesial 0.76 mm), whereas smokers showed stable papillae (between cohorts: P ≤ 0.025). Midfacial soft tissue level demonstrated statistically significant regrowth in non-smokers (0.53 mm), whereas it remained stable in smokers (between cohorts: P = 0.004).
  
  
  CONCLUSIONS
  Smokers failed to demonstrate papilla regeneration and showed more midfacial recession following single implant treatment when compared to non-smokers.
authors.affiliation: Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Raes
authors.affiliation: Private Practice, Chieti, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rocci
authors.affiliation: Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.
authors.forename: Filiep
authors.initials: F
authors.lastname: Raes
authors.affiliation: Department of Prosthodontics, University of North Carolina School of Dentistry, Chapel Hill, NC, USA.
authors.forename: Lyndon
authors.initials: L
authors.lastname: Cooper
authors.affiliation: Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.|Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.
authors.forename: Hugo
authors.initials: H
authors.lastname: De Bruyn
authors.affiliation: Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.|Department of Periodontology, Dental Medicine, Faculty of Medicine and Pharmacy, Free University of Brussels (VUB), Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Cosyn
mesh_terms: D000328:Adult; D003442:Crowns; D019250:Dental Implants, Single-Tooth; D003771:Dental Papilla / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*; D017695:Soft Tissue Injuries / Q000139:chemically induced*
keywords: dental implant; prospective study; single tooth; smoking; soft tissues