Habitual cigarette-smoking represents a risk factor for the development of peri-implant soft tissue inflammation that may lead to loss of supporting alveolar bone around the implants and implant and, consequently, implant loss [1-3]. Therefore, dentists should advise the patients to stop smoking before undergoing any dental implant treatment.
The study of Dr. Alsahhaf and collaborators published in 2019 aimed to evaluate the clinical performance of bone-level narrow-diameter Titanium-Zirconium (Ti-Zr, Roxolid) and Titanium (Ti) implants placed in compromised health patients, namely cigarette smokers [4].
One of the study investigators, Prof Tariq Abduljabbar, says: «The stability of the crestal bone level plays an essential role in the success of dental implant rehabilitation. We investigated the soft and hard tissue response in patients with Ti-Zr-SLActive implants in comparison to Ti-SLActive implants, with respect to smoking as a risk factor.»
The studied group included 96 partially edentulous patients and consisted of 47 cigarette-smokers, 49 never-smokers. Straumann Ti and Ti-Zr bone level implants with the SLActive surface were placed in those patients and followed for five years. The clinical parameters assessed during the study included implant survival and success rates followed by mesial and distal crestal bone level, plaque index, bleeding on probing, and pocket depth [4].
After 5 years, all implants were fully functional, resulting in a survival and success rate of 100% in all studied groups. Additionally, no statistically significant difference in both mesial and distal crestal bone level, plaque index, bleeding on probing, and pocket depth between the cigarette-smokers and never-smokers were observed. Also, both peri-implant mucositis and peri-implantitis were not diagnosed in any patient throughout the entire study duration [4]. Therefore, continues Prof. Abduljabbar, «it is suggested that Titanium and Titanium-Zirconium implants with SLActive surface are clinically and radiographically stable in smokers as long as routine and hygiene maintenance is performed.»
This interesting publication complements existing and continuously growing scientific evidence confirming that Straumann dental implants with SLActive surface represent a safe and predictable treatment option for compromised health conditions [5-10]. However, appropriate patient information followed by proper treatment planning and adequate post-surgical maintenance should be considered in these patients.
Testimonial (Prof Tariq Abduljabbar)
The stability of crestal bone levels play an essential role in the success of dental implant rehabilitations. We at Uranus Dental Centre have vast experience of Titanium implants (SLActive) by ITI Straumann in clinical cases showing excellent bone and soft tissue stability. However, with the incorporation of Zr to Ti implants (TiZr implants - Roxolid, Straumann ITI) (85% Ti and 15% Zr), studies have reported improved tensile and fatigue strength of implants. Although it has been in use, we decided to investigate the soft and hard tissue response in patients with Ti-Zr implants in comparison to Ti implants with respect to smoking as a risk factor. It was observed that Ti-Zr (Roxolid, Straumann ITI) implants showed 100% success and survival rates, which was similar to Ti implants at 5 years follow-up. Therefore, it is suggested that Ti and Ti-Zr implants are clinically and radiographically stable in smokers as long as long as routine and hygiene maintenance is performed.
References
- Sanchez-Perez A et al. 2007 J Periodontol 2007;78:351–9
- Bain CA and Moy PK 1993 Int J Oral Maxillofac Implants 1993;8:609–15
- Veitz-Kcenan A. Evid Based Deni 2016;17:6-7
- Alsahhaf A et al. Chin J Dent Res. 2019;22(4):265-272
- Attia M et al. Data presented at the annual AO meeting, March 13-16, 2019, Washington DC, USA 2019
- Khandelwal N et al. Clin Oral Implants Res. 2013 Jan;24(1):13-9
- Schlegel KA et al. Clin Oral Implants Res. 2013 Feb;24(2):128-34
- Cabrera-Domínguez JJ et al. Clin Oral Investig. 2019 Nov 7
- Chen Y et al. data resented at the ITI World Symposium, Basel, May 4-6, 2017 |
- Nelson K et al. J Oral Rehabil. 2016 Nov;43(11):871-872
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