Balshe Ayman A, Eckert Steven E, Koka Sreenivas, Assad Daniel A, Weaver Amy L
Department of Dental Specialties, Mayo Clinic, Rochester, Minnesota, USA.
Int J Oral Maxillofac Implants. 2008 Nov-Dec;23(6):1117-22.
To compare the long-term survival rates of smooth- and rough-surface dental implants among smokers and nonsmokers.
A retrospective chart review was conducted for 2 time periods: January 1, 1991, through December 31, 1996, during which smooth-surface implants were utilized, and January 1, 2001, through December 31, 2005, during which rough-surface implants were utilized. This review included all implants placed and restored in 1 institution during the 2 timeframes. Data were specifically collected relative to patient age, gender, smoking status, implant diameter, implant length, and anatomic location of implants. Implants from the first and second time periods were followed through mid-1998 and mid-2007, respectively. Associations of patient/implant characteristics with implant survival were evaluated using marginal Cox proportional hazards models (adjusted for age and gender) and summarized with hazard ratios (HR) and corresponding 95% confidence intervals (CI).
A total of 593 patients (322 [54.3%] female; mean [SD] age, 51.3 [18.5] years) received 2,182 smooth-surface implants between 1991 and 1996, while 905 patients (539 [59.6%)] female; mean [SD] age, 48.2 [17.8] years) received 2,425 rough-surface implants between 2001 and 2005. Among the rough-surface implants, smoking was not identified as significantly associated with implant failure (HR = 0.8; 95% CI = 0.3 to 2.1; P = .68). In contrast, smoking was associated with implant failure among the group with smooth-surface implants (HR = 3.1; 95% CI = 1.6 to 5.9; P < .001). Implant anatomic location was not associated with implant survival among patients with rough-surface implants (P = .45) and among nonsmokers with smooth-surface implants (P = .17). However, anatomic location affected the implant survival among smokers with smooth-surface implants (P = .004). In particular, implant survival was the poorest for implants placed in the maxillary posterior areas of smokers.
Based on this retrospective study, the following observations were made: Smoking was identified as a risk factor for implant failure of smooth-surface implants only; among the smokers who received smooth-surface implants, an association was identified between implant failure and location of the implant placement; no association was identified between implant failure and location among the smokers who received rough-surface implants.
比较吸烟者和非吸烟者中光滑表面与粗糙表面牙种植体的长期存活率。
对两个时间段进行回顾性病历审查：1991年1月1日至1996年12月31日，此期间使用光滑表面种植体；2001年1月1日至2005年12月31日，此期间使用粗糙表面种植体。该审查包括在这两个时间段内在1个机构植入并修复的所有种植体。专门收集了有关患者年龄、性别、吸烟状况、种植体直径、种植体长度以及种植体解剖位置的数据。分别对第一和第二个时间段的种植体随访至1998年年中及2007年年中。使用边际Cox比例风险模型（针对年龄和性别进行调整）评估患者/种植体特征与种植体存活的关联，并用风险比（HR）和相应的95%置信区间（CI）进行总结。
1991年至1996年期间，共有593例患者（322例[54.3%]为女性；平均[标准差]年龄为51.3[18.5]岁）接受了2182枚光滑表面种植体，而2001年至2005年期间，905例患者（539例[59.6%]为女性；平均[标准差]年龄为48.2[17.8]岁）接受了2425枚粗糙表面种植体。在粗糙表面种植体中，未发现吸烟与种植体失败有显著关联（HR = 0.8；95%CI = 0.3至2.1；P = 0.68）。相比之下，在光滑表面种植体组中，吸烟与种植体失败有关联（HR = 3.1；95%CI = 1.6至5.9；P < 0.001）。种植体解剖位置与粗糙表面种植体患者（P = 0.45）以及非吸烟的光滑表面种植体患者（P = 0.17）的种植体存活无关。然而，解剖位置影响吸烟的光滑表面种植体患者的种植体存活（P = 0.004）。特别是，在上颌后部区域植入的吸烟患者的种植体存活率最差。
基于这项回顾性研究，得出以下观察结果：吸烟仅被确定为光滑表面种植体失败的一个风险因素；在接受光滑表面种植体的吸烟者中，确定种植体失败与种植体植入位置之间存在关联；在接受粗糙表面种植体的吸烟者中，未发现种植体失败与位置之间存在关联。
