What Effect Does Smoking Have on Bone Grafts for Dental Implants?

Smoking has toxins as well as nicotine which is a vasoconstrictor (decreases size of lumen of blood vessels) which in turn drastically reduces the blood supply to the surgical site and bone graft. As well, a smaller blood vessel cannot move toxins and waste as quickly away from the surgical site. All told, not having enough nutrients and oxygen reaching the bone graft and not being able to rid the site of toxins will have a deleterious effect on the graft. The scientific literature is replete with examples and studies demonstrating that smokers have a significantly higher chance of failure over non-smokers. Having said that, there are many patient who smoke who proceed with surgeries of various kind and are successful. It's jus that your RISK of complications is significantly higher, depending on the type of procedure. 

Dental implants are one of the most successful procedures in dentistry, with a success rate of ~95%.  Studies show that in people who smoke the success rate drops to somewhere between 50%-70%.  The body just doesn’t heal correctly when you smoke.  I’ve experienced firsthand how poorly implants work in smokers.  For that reason I decided to no longer place dental implants in people who smoke.  

I’m very proud that I’ve been able to help many people quit smoking after which we successfully placed dental implants.  It feels very rewarding to not only improve someone’s oral health, but to save their life.  For people who were unable to quit smoking, we explored other plausible options.  Such as bridge work or flexi-dentures, these patients were also satisfied with their results.  They were also grateful for not having to go through the trouble of implant failure.  Good Luck!

Smoking can adversly effect the healing during the initial phases of both bone graftig and dental implants. I advise my patients to avoid it during the two months period after surgery. Even after that, it's best to avoid it, but its effect may not be as adverse at later times.

Dr. Kazemi
 

Smokers often don't do as well with dental implants as non-smokers. I have seen several patients who were either longtime heavy smokers or continuing to smoke after implant placement whose implants failed. It may not be as important after the implant is integrated and healing complete, but smoking is a known risk factor. Dental implants are not inexpensive, making sure your implants are successful would be a great reason to quit smoking.

Implant success is very high but anytime smoking  occurs during the initial stages after the placement it will affect the success of the integration of the implant to the bone.  I would highly recommend for you to refrain from smoking for as long as possible.  If you can do that for one to two weeks the success rate will be greater.  This would apply to the bone graft that might be used as well.

When implants are placed they depend on blood supply in our jaws to help the implant integrate. Nicotine is a vasoconstrictor that squeezes the vessels and prevents the cells getting to the area to help healing.

When considering implant surgery, you should make sure you are NOT smoking or your chances of good healing is greatly diminished

A person that smokes has decreased blood flow, so they don't heal as well.  A bone graft requires a good blood supply, and smokers won't give that.  SOMETIMES a person can stop smoking for a short time, allow the graft to heal or implant to integrate, and then continue smoking.  This MAY help with the implants (but not the overall health).

Patients with the history of heavy smoking (more than 1 pack a day) have according to multiple research hidher rate of implant failures, in certain studies even higher rate than diabetic or immuno-compromised patients. This rate can fell from 98% in healthy individuals to 70-85%. Usually smoking has 2 different effects on the bone and soft tissue: spasm of blood vessels in the body, especially in the oral cavity due to nicotine and the heating effect equal to chronic burn of soft tissue in the mouth. These two pathways together increase the local temperature in the oral cavity, lead to slow blood supply and higher risks of infections, which can lead to implant and especially soft and bone graft failures. It`s proven that smokers have higher ( up to 80%) risk of oral cancer.