THE EFFECT OF SMOKING ON EARLY IMPLANT FAILURE

This retrospective study describes the effect of smoking on initial fi xture failure before functional loading with fixed prosthetic restorat ions. Of 208 installed Branemark fixtures in the mandible, only 1 fail ed (0.5%), and no detrimental effect of smoking on fixture survival co uld be detected. In the maxilla, 10/244 fixtures failed (4%); 7/78 fix tures failed in smokers and 3/166 in nonsmokers. The failure rate befo re loading was 9% in smokers versus 1% in nonsmokers and was statistic ally significant, despite the fact that bone quality in both groups wa s comparable. Failed fixtures occurred in 31% of the smokers, despite often excellent bone quality, long fixture length or good initial stab ility. Only 4% of the nonsmokers had failures, in most cases related t o poor bone quality. It is concluded that smoking is a significant alt hough not the only important factor in the failure of implants prior t o functional loading. Prospective studies are needed to assess the ris k of implant failure in conjunction with smoking. In the mean time, pa tients should be informed of the adverse effect of smoking.