The effect of cigarette smoking on dental implants and related surgery

Cigarette smoking is still considered a common habit. Of smokers, increased plaque accumulation, higher incidence of gingivitis and periodontitis, higher rate of tooth loss, and increased resorption of the alveolar ridge have been found in the oral cavity. Cigarette smoking may adversely affect wound healing, and, thus, jeopardize the success of bone grafting and dental implantation. Bone grafts and sinus lift operations are both common and well-documented procedures before dental implant placement. Heat as well as toxic by-products of cigarette smoking, such as nicotine, carbon monoxide, and hydrogen cyanide, have been implicated as risk factors for impaired healing, and, thus, may affect the success and complications of those surgical procedures. An association among dental implants, grafting procedures (i.e., bone grafts, maxillary sinuses augmentation), and history of smoking has been reported. A higher degree of complication, or implant failure rates, were found in smokers with and without bone grafts. The relationship between cigarette smoking and implant-related surgical procedures, including the incidence of complications associated with these procedures, will be described and discussed based on relevant literature and results of our recent studies.     

Effects of smoking on the outcome of implant treatment: a literature review.

STATEMENT OF PROBLEM: The use of osseointegrated implants as a foundation for the prosthetic replacement of missing teeth has become widespread in the last decade. Owing to the remarkable success of dental implants, there has been growing interest in identifying the factors associated with implant failure. Given the well-documented deleterious effect of smoking on wound healing after tooth extraction and its association with poor quality bone and periodontal disease, a negative effect of tobacco use on implant success is to be expected. PURPOSE: To establish the relationship between smoking and implant-related surgical procedures (i.e, sinus lift procedures, bone grafts and dental implants), including the incidence of complications related to these procedures and the long-term survival and success rates of dental implants among smokers and nonsmokers based on relevant literature.MATERIALS AND METHODS: Relevant clinical studies published in English between 1990 and 2006 were reviewed. The articles were located through Medline and, manually, through the references of peer-reviewed literature. This was supplemented with a hand search of selected dental journals and text books.RESULTS: The majority of the past and current literature implicates smoking as one of the prominent risk factors affecting the success rate of dental implants with only a handful of studies failing to establish a connection. Most of the studies report the failure rate of implants in smokers as being more than twice that in nonsmokers. These findings are difficult to ignore. There is a statistically significant difference between smokers and nonsmokers in the failure rates of dental implants. Smoking also has a strong influence on the complication rates of implants: it causes significantly more marginal bone loss after implant placement, it increases the incidence of peri-implantitis and affects the success rates of bone grafts. The failure rate of implants placed in grafted maxillary sinuses of smokers is again more than twice that seen in nonsmokers.Conclusion: Smokers have higher failure rates and complications following dental implantation and implant-related surgical procedures. The failure rate of implants placed in grafted maxillary sinuses of smokers is more than twice that seen in nonsmokers.     

Smoking interferes with the prognosis of dental implant treatment: a systematic review and meta-analysis

AIM: This systematic literature review was performed to investigate if smoking interferes with the prognosis of implants with and without accompanying augmentation procedures compared with non-smokers. METHODS: A systematic electronic and handsearch (articles published between 1989 and 2005; English and German language; search terms "dental or oral implants and smoking"; "dental or oral implants and tobacco") was performed to identify publications providing numbers of failed implants, related to the numbers of smokers and non-smokers for meta-analysis. Publications providing statistically examined data of implant failures or biologic complications among smokers compared with non-smokers were included for systematic review. RESULTS: Of 139 publications identified, 29 were considered for meta-analysis and 35 for systematic review. Meta-analysis revealed a significantly enhanced risk for implant failure among smokers [implant-related odds ratio (OR) 2.25, confidence interval (CI(95%)) 1.96-2.59; patient-related OR 2.64; CI(95%) 1.70-4.09] compared with non-smokers, and for smokers receiving implants with accompanying augmentation procedures (OR 3.61; CI(95%) 2.26-5.77, implant related). The systematic review indicated significantly enhanced risks of biologic complications among smokers. Five studies revealed no significant impact of smoking on prognosis of implants with particle-blasted, acid-etched or anodic oxidized surfaces. CONCLUSION: Smoking is a significant risk factor for dental implant therapy and augmentation procedures accompanying implantations.     

3D数字化种植导板牙龈不翻瓣与翻瓣对口腔种植治疗效果的影响

目的 基于锥形束电子计算机断层扫描(CBCT)探讨3D数字化种植导板牙龈不翻瓣与翻瓣对口腔种植治疗效果的影响.方法 2019年1月～2020年1月医院口腔修复科收治入院治疗的72例牙列缺失患者,按照患者意愿和实际情况分为不翻瓣组和翻瓣组,不翻瓣组经CBCT设计制作不翻瓣颌骨模型和种植导板,翻瓣组经CBCT设计制作翻瓣颌...     

颌骨放疗区种植修复及其并发症防治的研究进展

手术结合放射治疗是口腔颌面部肿瘤的常规治疗手段。近年来,越来越多的患者选择种植牙修复口腔颌面部术后缺失的牙齿。种植体与周围骨组织形成良好的骨结合是种植牙成功的关键。然而,放疗后颌骨组织会遭受一定的损伤,影响种植体的骨结合成功率,增加并发症的风险。该文就颌骨放疗区种植修复及其并发症防治的研究进展作一综述。     

Fumo,alcol e salute orale

Objectives

Cigarette smoking, the second cause of death worldwide, and alcohol abuse, a leading cause of mortality and morbidity, are major risk factors for oral diseases. The aim of this paper is to present the effects of cigarette smoking and alcohol abuse on oral health. Specific strategies are also proposed to develop smoking cessation interventions in the office practice of dentists and dental hygienists providing.

Materials and methods

Original papers, reviews and guidelines on this subject, published in English and in Italian from 2006 to the first trimester of 2013, were located in the Medline/Pubmed database. Additional publications were obtained by searching the reference list of retrieved works.

Results and conclusions

Cigarette smoking is the most important risk factor for oral squamous cell carcinoma and potentially malignant oral lesions; alcohol abuse increases oral cancer risk in a synergistic fashion. Moreover, cigarette smoking is the second risk factor for chronic periodontitis, after dental plaque, whereas further studies are needed to assess the role of alcohol consumption on onset and progression of chronic periodontitis. The “Five A's” approach represents an effective protocol for smoking cessation that members of dental team can use with all smoker patients. The patients attempting to quit should use the nicotine replacement therapy, sustained-release bupropion or varenicline in order to significantly increase success rate of quit attempt.     

高龄老年患者人工牙种植术的围手术期护理

目的：探讨高龄患者人工牙种植术临床配合与护理要点,提高老年种植牙手术的成功率。方法：根据老年生理改变及心理变化的特点,在术前做好充分准备,术中采取相应的配合和术后正确的口腔护理措施。结果：本组50例老年种植牙患者种植后,经随访3个月～2年,均形成良好的骨结合,无种植体脱落及牙龈炎等并发症。结论：采用微创种植技术,对老年种植患者术前、术中、术后三个阶段实施精心护理,避免了切口感染,促进切口愈合,提高了老年种植牙手术的成功率。     

Why and how to get patients to stop smoking

Despite the fact that smoking cigarettes harms oral and systemic health, there is little current evidence of successful primary dental care involvement in smoking cessation.This paper aims to present the arguments for developing the role of primary dental care in smoking cessation and reviews the current literature on how this can be achieved in practice. It is argued that it is timely to incorporate this rapidly developing evidence base on what works in smoking cessation into primary dental care activity.     

牙种植外科技术探讨

牙种植外科技术是牙种植学的重要组成部分之一，它直接关系到牙种植的成功与失败。本文结合几年来的临床实践，介绍了牙种植患者的术前评估、治疗设计，重点对于该手术的外科手术问题进行探讨。文章还对该手术的注意事项，如何保证正确的种植部位与方向，防止副损伤等问题介绍了作者的体会。     

牵张成骨和引导骨再生术在垂直骨增量上的比较研究

随着种植外科的进展,大量垂直向和水平向骨增量技术得到了发展。许多种植患者存在垂直向骨量不足的问题,需要增加垂直向骨量;但垂直向骨增量相对于水平向骨增量难度比较大,预见性较差,往往易致较多的并发症;因此,垂直向骨增量技术受到了越来越多的关注。引导骨再生技术和牵张成骨术是2类较常用的垂直向骨增量技术,在临床上已得到一定的应用,本文对其在垂直向骨增量上的研究进展作一综述。     

Implant reversible complications: classification and treatments

Failures of dental implants are detrimental to both patients and dental providers. These failures are often preceded by complications at various levels of the treatment phases. Early detection of the complications that are amenable to rescue therapies may reverse the fate of the implant. This review article discusses diagnosis, classification, and treatment aspects of the reversible complications commonly encountered during routine dental implant-related procedures.     

Use of piezosurgery device in management of surgical dental implant complication: a case report

An implant displacement into the maxillary sinus could be a complication of implant surgery in the upper jaw. In such cases, implant removal is needed to avoid the occurrence of sinus pathologies. Piezosurgery techniques could assure safer management of such complications because of clear surgical visibility and a selective ability to cut. The aim of this report is to present a case of an implant-related oral surgery complication that was resolved by means of a piezosurgery technique.     

Dental management of patients receiving anticoagulation or antiplatelet treatment

Antiplatelet and anticoagulant agents have been extensively researched and developed as potential therapies in the prevention and management of arterial and venous thrombosis. On the other hand, antiplatelet and anticoagulant drugs have also been associated with an increase in the bleeding time and risk of postoperative hemorrhage. Because of this, some dentists still recommend the patient to stop the therapy for at least 3 days before any oral surgical procedure. However, stopping the use of these drugs exposes the patient to vascular problems, with the potential for significant morbidity. This article reviews the main antiplatelet and anticoagulant drugs in use today and explains the dental management of patients on these drugs, when subjected to minor oral surgery procedures. It can be concluded that the optimal INR value for dental surgical procedures is 2.5 because it minimizes the risk of either hemorrhage or thromboembolism. Nevertheless, minor oral surgical procedures, such as biopsies, tooth extraction and periodontal surgery, can safely be done with an INR lower than 4.0.     

Factors related to acceptance of dental treatment services in a nursing home population

This study reports on factors related to acceptance of restorative, oral surgery, and prosthodontic dental treatment services by a population of nursing home residents. Lower cost treatment plans and eligibility for Medicaid benefits were associated with acceptance of all treatment, and for the categories of oral surgery and prosthodontic services. Acceptance of routine restorative procedures was more strongly associated with female residents. It is concluded that financial concerns appear to pose the greatest barrier in providing dental treatment services to nursing home residents.     

Coronal positioning of tissue previously treated with freeze-dried dura mater grafts. Report of a case

Root surfaces exposed to the oral environment may present a variety of problems to dental patients. Mucogingival surgical procedures represents one approach to the management of these concerns. Procedures currently in use often require two or three wounds, and sometimes two surgical sessions. Recent observations suggest that an allograft, freeze-dried dura mater, amy serve as a donor material in mucogingival surgery. This report describes the use of coronally positioned flap procedures to treat residual areal of recession 4 years after placement of freeze-dried dura mater allografts.     

种植牙术后全身与局部用药对PCT、CRP的影响及治疗效果研究

目的:探讨口腔种植牙术后全身与局部抗感染对降钙素原(PCT)、C-反应蛋白(CRP)的影响及治疗效果,为临床研究提供参考依据。方法:选择2014年1月~2015年11月120例行口腔种植牙的患者作为研究对象,采用随机数字表法分为全身组与局部组各60例,在常规治疗基础上全身组给予奥硝唑治疗,局部组在制备好的种植窝洞内及切口部位给予盐酸米诺环素治疗。于治疗前及治疗后3 d抽取静脉血检测PCT、CRP水平,并比较两组术后疼痛及疗效差异。结果:局部组总有效率95.0%明显高于全身组83.3%,差异有统计学意义(P<0.05)。局部组疼痛发生率41.7%比例明显低于全身组60.0%,差异有统计学意义(P<0.05)。结论:口腔种植牙行局部抗感染治疗疗效及止痛效果明显好于全身治疗患者。     

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随着我国人口逐渐步入老龄化以及口腔种植技术的不断发展,老年人行上颌窦提升术的比例越来越高。临床须全面评估风险因素才能提高手术成功率。术前医生需掌握老年患者的全身及局部病史,充分了解上后牙区骨质、骨量、颌位关系以及上颌窦的解剖生理状态;术中掌握正确的外科技术、骨移植方案及种植体植入时机。本文将对老年人上颌窦提升术的相关问题进行探讨。     

Maintenance of gingival health post professional care

Oral hygiene habits are strongly associated with general health behaviours; good oral self care should result in good dental health. Clinical dental hygiene services have limited long range probability of success if the patient is not diligent in the daily procedures of personal care to remove and control dental plaque. Therefore, it is important to help make the individual aware of their own ability to control and maintain good oral health after a dental prophylaxis through oral care instruction and the use of select antimicrobials to maintain the gingival health. This paper reviews the evidence outlining the relative roles of prophylaxis and correct oral self-care in maintaining gingival health.     

Image-guided navigation system for placing dental implants

Navigation-guided surgery has recently been introduced into various surgical disciplines, including oral and maxillofacial surgery. Since the advent of dental implants, dental computed tomography (CT) scans have been used as a diagnostic tool for preoperative planning, but not as part of the surgical phase. This article explains the principles of computer-assisted surgery and describes the use of a computer-guided navigation system in dental implantology. The system uses preoperative dental CT scans for planning and as an integral part of the surgical procedure. This system allows continuous intraoperative coordination of the implantation phase with the preoperative plan, optimizing the accuracy of implant surgery. Deviations from the planned location of the implants are minimal. Several cases are discussed.