title: The effect of cigarette smoking on early osseointegration of dental implants: a prospective controlled study.
abstract: OBJECTIVE
  This study evaluated the effect of cigarette smoking on the percentage of early bone-to-implant contact (BIC%), the bone density in the threaded area (BA%) as well as the bone density outside the threaded area (BD%) around micro-implants with sandblasted acid-etched surface retrieved from human jaws.
  
  
  METHODS
  Twenty-two subjects (mean age 55.4 ± 4.5 years) were divided in two groups: smokers (n = 11 subjects) and never-smokers (n = 11 subjects). Each subject received one micro-implant during conventional mandible or maxilla implant surgery. After 8 weeks, the micro-implants and the surrounding tissue were removed and prepared for histomorphometric analysis.
  
  
  RESULTS
  Two micro-implants placed in smokers showed no osseointegration. Early stages of maturation of the newly formed bone were present, mainly in the never-smokers. Marginal bone loss, gap, and fibrous tissue were present around some implants retrieved from smokers. Histometric evaluation indicated that the mean BIC% ranged between 25.9 ± 9.1 and 39.8 ± 14.2 for smokers and non-smokers, respectively (P = 0.02). Smokers presented 28.6 ± 10.1 of BA% while never-smokers showed 46.4 ± 18.8 (P = 0.04). The mean of BD% ranged between 19.1 ± 7.6 and 28.5 ± 18.8 for smokers and never-smokers, respectively (P = 0.21).
  
  
  CONCLUSIONS
  Cigarette smoking has a detrimental effect on early bone tissue response around sandblasted acid-etched implant surface topographies.
authors.affiliation: Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil.
authors.forename: José Divino
authors.initials: JD
authors.lastname: Bezerra Ferreira
authors.affiliation: Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil.
authors.forename: Jose Augusto
authors.initials: JA
authors.lastname: Rodrigues
authors.affiliation: Department of Oral Medicine and Pathology, University of Chieti-Pescara, Chieti, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Piattelli
authors.affiliation: Department of Oral Medicine and Pathology, University of Chieti-Pescara, Chieti, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Iezzi
authors.affiliation: Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil.
authors.forename: Sergio Alexandre
authors.initials: SA
authors.lastname: Gehrke
authors.affiliation: Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil.
authors.forename: Jamil Awad
authors.initials: JA
authors.lastname: Shibli
mesh_terms: D000539:Alveolar Process / Q000187:drug effects / Q000473:pathology; D015519:Bone Density; D003758:Dental Implantation, Endosseous; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000187:drug effects; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*
keywords: Implant surface topography; dental implants; human histology; osseointegration; smoking; wound healing