Smoking and alcohol consumption
Cigarette smoking must be considered as a potential risk factor with a strong influence the maintenance of endosseous dental implant. Avoidance of chemotaxis and phagocytosis, polymorphic cellular granulocytes, a stimulation of proinflammatory cytokines and direct encouragement of subgingival anaerobic should be encouraged in early and late complications after implant insertion. Furthermore, nicotine and its metabolites influence the metabolism of connective tissue and bone through the inhibituion of collagen synthesis and a reduction of the intestinal absorption of Ca 2+ (Kan et al) retrospectively examined the effects of smoking on the success rate of implants in preceding sinus floor elevation. After an average observation period of 41.6 months, a significationly higher successful prognosis (82.7%) could be made in nonsmokers than in smokers (65.3%). The number of cigarette had no addition influenceon the successful prognosis in the group of smokres. Comparable results were also observed in the prospertive, multicenter examination of 800 patients with a total of 2900 implants over a period of 3 years. The greatest failures, however, were not determined in the period between implant insertion and uncovering, but rather after the exposure until the integration of the superstructures. The lowest failures were found in implants with HA coating. Owing to the vasoconstristive features of nicitine, the clinical assessment of the peri-implant inflammation condition with lack of bleeding on probing can be incorrectly evaluated as negative.
Substantial evidence suggests an association between smoking and marginal bone loss and peri-implantitis.
Previous examinations show a synergistic effect of possitive IL-1 genotypes and smoking on the biological complication rate of the implant healing.
(Frank SCHWARZ, Jurgen BECKER: Etiological factors. Peri-implant infection: Etiology, diagnosis and treatmet 2010; 60)