Effect of smoking habits on accuracy of implant placement using mucosally supported stereolithographic surgical guides.

BACKGROUND Smoking is considered as a factor for implant survival and peri-implant bone loss of dental implants. Several studies revealed the negative effect of smoking on osseointegration and its dose-related effect. PURPOSE To evaluate the effect of smoking habits on accuracy of implant placement using mucosally supported stereolithographic surgical guides. MATERIAL AND METHODS Six OsseoSpeed™ implants (Astra Tech AB, Mölndal, Sweden) were inserted into the maxilla in 13 patients. Patients were excluded if they suffered from any systemic disease or if they were actually taking any kind of medication. Software (Mimics® 9.0) was used to fuse images of the virtually planned and actually placed implants, and locations and axes were compared between the nonsmoking and smoking subgroups. As the mucosal biotype could probably influence accuracy data, 12 reference points were defined within each patient to define a mean mucosal thickness value. RESULTS In the smoking subgroup, 36 implants were placed compared with 42 in the nonsmoking subgroup. Mean coronal deviation was 1.04mm (range: 0.29-2.45mm) among the smokers compared with 0.80mm among the nonsmokers (range: 0.29-1.67mm). At apical point, mean deviation was 1.26mm (range: 0.39-3.01mm) among the smokers compared with 1.02mm among the nonsmokers (range: 0.32-2.59mm). Mean angular deviation was 2.64° (range: 0.41-6.81°) among the smokers compared with 2.57° among the nonsmokers (range: 0.16°-8.86°). Significant differences were found when comparing global coronal and apical deviation between the smokers and the nonsmokers (p<.05). Evaluating mucosal thickness, mean value was 3.19mm (range: 2.39-4.01mm) among the smokers compared with 2.43mm among the nonsmokers (range: 1.44-3.03mm). CONCLUSIONS Statistically significant differences were found when comparing the accuracy of dental implant placement of the smokers with the nonsmokers. Smokers have significant thicker supporting mucosal tissues compared with nonsmokers, which may explain inaccuracy due to less stability of the surgical guide or the scanning prosthesis.

[1]  C H Basten,et al.  The use of radiopaque templates for predictable implant placement. , 1995, Quintessence international.

[2]  Werner Jaschke,et al.  Use of a surgical navigation system for CT-guided template production. , 2007, The International journal of oral & maxillofacial implants.

[3]  Basten Ch,et al.  The use of radiopaque templates for predictable implant placement. , 1995 .

[4]  J L Coudert,et al.  Precise dental implant placement in bone using surgical guides in conjunction with medical imaging techniques. , 2000, The Journal of oral implantology.

[5]  E. Hanley,et al.  The Musculoskeletal Effects of Smoking , 2001, The Journal of the American Academy of Orthopaedic Surgeons.

[6]  Paul Suetens,et al.  A custom template and definitive prosthesis allowing immediate implant loading in the maxilla: a clinical report. , 2002, The International journal of oral & maxillofacial implants.

[7]  H Israelson,et al.  Barium-coated surgical stents and computer-assisted tomography in the preoperative assessment of dental implant patients. , 1992, The International journal of periodontics & restorative dentistry.

[8]  H. De Bruyn,et al.  The effect of smoking on early bone remodeling on surface modified Southern Implants®. , 2011, Clinical implant dentistry and related research.

[9]  M Abrams,et al.  Computer-guided surgery utilizing a computer-milled surgical template. , 2001, Practical procedures & aesthetic dentistry : PPAD.

[10]  David P Sarment,et al.  Stereolithographic surgical templates for placement of dental implants in complex cases. , 2003, The International journal of periodontics & restorative dentistry.

[11]  D Hoffmann,et al.  The changing cigarette, 1950-1995. , 1997, Journal of toxicology and environmental health.

[12]  T. van de Velde,et al.  A model study on flapless implant placement by clinicians with a different experience level in implant surgery. , 2007, Clinical oral implants research.

[13]  J. D'haese,et al.  A prospective study on the accuracy of mucosally supported stereolithographic surgical guides in fully edentulous maxillae. , 2012, Clinical implant dentistry and related research.

[14]  H. De Bruyn,et al.  Early loading of machined-surface Brånemark implants in completely edentulous mandibles: healed bone versus fresh extraction sites. , 2002, Clinical implant dentistry and related research.

[15]  H. De Bruyn,et al.  The effect of smoking on early implant failure. , 1994, Clinical oral implants research.

[16]  Patricia R Cury,et al.  Clinical application of stereolithographic surgical guides for implant placement: preliminary results. , 2005, Journal of periodontology.

[17]  R Jacobs,et al.  Accuracy of implant placement based on pre-surgical planning of three-dimensional cone-beam images: a pilot study. , 2007, Journal of clinical periodontology.

[18]  Guy Marchal,et al.  An image-guided planning system for endosseous oral implants , 1998, IEEE Transactions on Medical Imaging.

[19]  C. Bain,et al.  Smoking and implant failure--benefits of a smoking cessation protocol. , 1996, The International journal of oral & maxillofacial implants.

[20]  Guillaume Champleboux,et al.  Precision of transfer of preoperative planning for oral implants based on cone-beam CT-scan images through a robotic drilling machine. , 2002, Clinical oral implants research.

[21]  Predrag Sukovic,et al.  Accuracy of implant placement with a stereolithographic surgical guide. , 2003, The International journal of oral & maxillofacial implants.

[22]  K H Thunthy,et al.  Radiographic/surgical template incorporating metal telescopic tubes for accurate implant placement. , 1998, Practical periodontics and aesthetic dentistry : PPAD.