You’ve probably heard or read that smoking can be a risk factor for dental implant failure. But does that mean that you will turn away someone who smokes, telling them that they are not a candidate for dental implants?
Are you 100% sure that smoking is a risk factor?
Recently, I had a dental student tell me that smoking is NOT a risk factor for implant failure because of some study that showed that there was no difference in the success rates. I was doubtful, but I checked his reference and…he is right!…sort of.
This article will first describe the biology of how smoking affects bone repair, then briefly cover what the literature says, and finally provide some clinical suggestions for how to modify your treatment.
Angiogenesis and osteogenesis are essential to successful osseointegration of a dental implant.
It’s easy to understand why angiogenesis is important. The growth of new blood vessels brings oxygen and growth factors into the implant site, thereby facilitating healing.
It is a well-documented relationship:
Enhanced angiogenesis will lead to enhanced bone healing while inhibited angiogenesis will impair bone healing.
So do you think smoking enhances or inhibits angiogenesis?
According to a study by Ma in 2010 (they performed distraction osteogenesis on poor little rabbits!) smoking actually increased angiogenesis. (My mind was blown!)…but, at the same time, smoking also reduced blood flow.