Clinical Outcome of OsseoSpeed™ Immediately Loaded Single Implants in Healed Ridges: Non-smoker versus Smoker

It is commonly accepted that smoking is one of the risk factors for maintaining stable periodontal tissues around oral implants. The primary goal of this prospective clinical study was to compare the overall outcome of immediately loaded single implants (OsseoSpeedTM, Astra Tech Implant SystemTM) placed in healed ridges of non-smokers and smokers. The aim was to evaluate those groups for bone adaptation and soft tissue dimensions. Ninety-four patients in need of a single implant in the anterior maxilla (15-25) were treated in three different centers. The patients were divided into two groups depending on their smoking habits; smoker (n=47) or non-smiler (n=47). Smokers had to smoke 10 or mor cigarettes a day. The implants were placed in healed ridges. If regeneration was necessary or the implant could not be loaded, patients were allocated to another group or the exit group. 85 patients (46 smokers and 39 non-smokers) were included in the analysis. Patients were immediately provisionalized and permanent crowns were placed after 8 weeks ± 5 days. Marginal bone level, Gingival zenith score and Papilla Index were registered at different time points. 3 implants failed (6.5%) in the smoker group and non in the non-smoker group. The mean change in marginal bone level 1 year and 2 years after implant placement were - 0.39 (1.15) (loss) and -0.42 (1.16) in the non-smoker group and - 0.36 (0.75) and -0.44 (0.88) in the smoker group. The Gingival Zenith Score change was -0.14 (0.29) after 1 year and 0.1 (0.82) (loss) after 2 years, -0.72 (1.08) and -0.76 (0.96) for the medial papillae and -0.51 (0.71) and -0.63 (1.02) for the distal papillae. The smoker group showed recession in both medial en distal papillae after 2 years, 0.21 (1.31) and 0.14 (1.52). After 2 years the marginal bone level of the implant in both groups is comparable. A tendency for re-growth of the mid facial gingiva is seen in the non-smoker group. In the smoker group, there is a tendency of papillae loss after two years comparing with re-growht in the non-smoker group. The differences between the two groups may be due to the smoking habits.

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