Penam Periodontics - Evidence based Personalized Periodontics


Smoking and Implants.

The third major risk for late implant loss is smoking. People who smoke are an average between 3.5 and 4.5 fold increased risk rate of losing an implant. However the more cigarettes the greater the risk. Calculate your risk. If they also have periodontal disease the risk of loss is cumulative for both issues. The risk of implant loss posed by smoking seems to revolve around the failure to heal adequately in the immediate postsurgical phase of treatment, an increase in potential substrate (food) provision to the bacteria, and an immune suppression mechanism which appears to allow the bacteria to infect the sites more readily.

Smoking and delayed healing. Research has shown that smoking reduces the normal healing following surgery or for that matter any trauma. This fact places limitations upon how and when we place implants in smokers. Most clinicians advise cessation of smoking pre-surgery and during the surgical healing phase of implants.

Smoking and Immune suppression. People who smoke have increased levels of carbon monoxide, nicotine and many other components from cigarette smoke in their saliva and on their breath. These components are known to progressively result in loss of viability of the white blood cells that kill bacteria. The more cigarettes the lower the levels of viable active white blood cells. These simple factors reduce the ability of the body fight chronic bacterial infections such as periodontitis.

Smoking and bacterial substrate (food) supply. The bacteria in periodontal disease use components from our serum as a growth factors. These factors usually have a higher flow rate into the gum pockets the more inflammation in the tissue, which provides a greater source of food for the bacteria to grow on. Smoking increases the flow rate of serum into the pocket by 2-3 fold, which in turn increases the availability of the food for the bacteria. So smoking not only reduces the ability of the body to kill bacteria but also increases the growth rate of the bacteria we want to remove leading to increased implant loss.

QUITTING: is the best solution as that reduces the factors that can result in increased implant loss. [QUIT]

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