Effect of unfiltered cigarettes on marginal bone loss of dental implants: A single center 4-year retrospective clinical study.

PURPOSE: This retrospective clinical study evaluated, by radiographic analysis, the effect of unfiltered and filtered tobacco cigarette smoking on marginal bone loss (MBL) in the subjects with dental implants.

METHODS: In a 4-year retrospective clinical study, 419 dental implants were placed in 188 subjects aged 23-76 years who underwent implant-supported fixed prosthetic restorations. The effects of gender, implant length, implant diameter, implant location, and use of unfiltered and filtered tobacco cigarettes on marginal bone were investigated. MBL was analyzed on the mean, mesial, and distal surfaces of dental implants on periapical radiographs. The results of the data were statistically analyzed with ANOVA and Tukey test.

RESULTS: A significant correlation was found between MBL difference and gender, implant length, and implant location (P< 0.05). Smokers had significantly higher MBL than nonsmokers, both within and between groups (P< 0.05). There was a significant difference in MBL in the mesial region in unfiltered cigarette smokers compared to filtered cigarette smokers (P= 0.013). There was a significant increase in MBL in the mesial and distal region compared to heavy smokers of cigarettes without filters (>20 cigarettes/day) and heavy smokers of cigarettes with filters (>20 cigarettes/day) (P< 0.05).

CLINICAL SIGNIFICANCE: In this study, tobacco smoking had a negative effect on marginal bone loss. There was a significant increase in marginal bone loss on the mesial and distal surfaces, especially in unfiltered heavy tobacco smokers (>20 cigarettes/day).