Smoking and Implant

Smoking has several bad effects on general and dental health.  Mr. You was a smoker and had severe gum disease, partially related to smoking.  Three of his top molars were in bad shape (Fig.1: #1-3), particularly the 1st molar with a large bone defect (empty space) around the roots (arrowheads).  All of these molars were extracted (P in Fig.1-3: a premolar tooth).  He can not eat well and needs implants badly.  But success rate for dental implants is low in smokers, because smoking interferes with wound healing.  Finally Mr. You quits smoking for good.

But the bone around the previously 1st molar has shrunk since extraction 8 years ago (Fig.2 (cheek view): #1; Fig.3 (biting surface view, mirror image): ^).  With a proper bone expansion technique and implant placement (Fig. 4: I), the sunken bone returns to a normal shape (^).  After surgery, the patient is doing great.  The implant is expected to heal normally.  In all, we can safely place implants after smoking cessation (1, 2).

Xin Wei, DDS, PhD, MS 1st edition 01/25/2013, last revision 01/25/2013