Department of Oral and Maxillofacial Surgery, College of Dentistry, Mosul University, Mosul, Iraq.
Evid Based Dent. 2024 Mar;25(1):15-16. doi: 10.1038/s41432-023-00957-6. Epub 2023 Nov 30.
A retrospective cohort study involved patients who received at least one implant-supported restoration at a university dental clinic between 2001 and 2013. Patients were randomly selected from an electronic database, and their recruitment via telephone contact spanned from February 2021 until July 2021.
To investigate the association of smoking and its cessation with the risk of peri-implant mucositis and peri-implantitis in a cohort of implant-treated patients.
The study adhered to the principles outlined in the Declaration of Helsinki and followed the STROBE guidelines for reporting observational research. Included were adult patients who were rehabilitated with dental implants, irrespective of the type of edentulism, superstructure, and prosthetic retention, provided that they had adequate access for peri-implant probing. Patients with incomplete records were excluded. Clinical measurements included plaque and bleeding indices, periodontal pocket depth, suppuration on probing, mucosal recession, and width of keratinized mucosa. Periapical radiographs were taken and marginal bone level (MBL) was measured using ImageJ software. The primary outcome variable was peri-implant status which was classified into: health (H), peri-implant mucositis (PM), and peri-implantitis (PI). Smoking status was categorized into: never-smokers, former smokers, and current smokers. Smoking information included: daily cigarette consumption, duration of smoking (in years), and age at initiation, and for former smokers, the duration of smoking cessation.
The cohort included 117 patients (55 females and 62 males) with a mean age of 64.2 years at examination. They were rehabilitated by 450 implants, with an average of 4.6 implants per patient and a mean duration of 8 years in function. Out of the total, 39 patients were H, while 41 and 37 showed PM and PI, respectively. Periodontal and MBL measures were significantly higher in PM and PI groups compared to H group (p < 0.001). Considering tobacco use, 56 patients were never-smokers, 42 former smokers, and 19 current smokers. The average daily consumption of cigarettes was 15.7. Ever-smokers >23 pack-years had a significantly higher risk for PI (OR = 3.40; 95% CI 0.91-17.30; p = 0.002) compared to nonsmokers. Regression analysis showed that subjects with a span since smoking cessation of more than 21 years exhibited a significantly lower risk of peri-implant diseases (PIDs) than those who had ceased smoking within 21 years (p = 0.028).
A smoking intensity exceeding 23 pack-years was significantly associated with PI risk, while the risk of PIDs was comparable between never-smokers and those who had quit smoking more than 21 years ago.
这是一项回顾性队列研究，涉及 2001 年至 2013 年间在一所大学牙科诊所接受至少一项种植体支持修复的患者。患者从电子数据库中随机选择，并通过电话联系进行招募，招募时间从 2021 年 2 月持续到 2021 年 7 月。
调查吸烟及其戒烟与种植体治疗患者群体中种植体周围黏膜炎和种植体周围炎风险的关系。
该研究遵循《赫尔辛基宣言》中概述的原则，并遵循 STROBE 指南报告观察性研究。纳入的是接受牙种植体修复的成年患者，无论缺牙类型、上部结构和修复体保留方式如何，只要有足够的种植体探诊通道即可。排除记录不完整的患者。临床测量包括菌斑和出血指数、牙周袋深度、探诊时溢脓、黏膜退缩和角化黏膜宽度。拍摄根尖片，并使用 ImageJ 软件测量边缘骨水平（MBL）。主要结局变量是种植体状态，分为：健康（H）、种植体周围黏膜炎（PM）和种植体周围炎（PI）。吸烟状况分为：从不吸烟者、曾经吸烟者和当前吸烟者。吸烟信息包括：每天吸烟量、吸烟年限（年）和开始吸烟年龄，对于曾经吸烟者，还包括戒烟年限。
该队列包括 117 名患者（55 名女性和 62 名男性），检查时的平均年龄为 64.2 岁。他们通过 450 个种植体进行了修复，平均每位患者植入 4.6 个种植体，功能平均持续 8 年。其中，39 名患者为 H，41 名和 37 名患者分别为 PM 和 PI。与 H 组相比，PM 和 PI 组的牙周和 MBL 测量值明显更高（p<0.001）。考虑到烟草使用情况，56 名患者为从不吸烟者，42 名患者为曾经吸烟者，19 名患者为当前吸烟者。平均每天吸烟量为 15.7 支。曾经吸烟超过 23 包年的患者患 PI 的风险显著增加（OR=3.40；95%CI 0.91-17.30；p=0.002），与不吸烟者相比。回归分析显示，戒烟超过 21 年的患者发生种植体周围疾病（PIDs）的风险明显低于戒烟 21 年内的患者（p=0.028）。
吸烟强度超过 23 包年与 PI 风险显著相关，而从不吸烟者和戒烟超过 21 年的患者发生 PIDs 的风险相当。
