Effect of smoking intensity on clinical outcomes of implants placed with simultaneous guided bone regeneration: a 5-year retrospective study.

PURPOSE This study investigated the dose-dependent impact of smoking intensity on marginal bone loss (MBL) and the rates of implant survival and failure in patients undergoing implant placement with simultaneous guided bone regeneration (GBR) over a 5-year follow-up period.

METHODS A retrospective cohort analysis was performed on 55 patients (130 implants) who were stratified by smoking intensity (10 or 20 cigarettes/day). MBL was assessed radiographically, and clinical outcomes were analyzed using Kaplan-Meier survival curves and multivariate logistic regression.

RESULTS At 5 years, smokers consuming >10 cigarettes/day exhibited significantly greater MBL than did non-smokers and light smokers (2.67 mm vs. 1.34-1.40 mm; P < 0.001). Heavy smokers (>20 cigarettes/day) showed the highest MBL (2.88 mm). Multivariate analysis identified smoking ≥20 cigarettes/day (odds ratio = 16.7) and the use of non-resorbable membranes (odds ratio = 10.4) as primary independent risk factors for failure. The 5-year survival rate remained 100% for non-smokers and light smokers (≤10 cigarettes/day) but decreased significantly to 88.1% for those exceeding 10 cigarettes/day.

CONCLUSIONS Smoking intensity has a profound, dose-dependent negative effect on GBR-supported implants. Consumption of more than 10 cigarettes/day significantly accelerates bone loss and diminishes implant survival, identifying heavy smoking as a critical risk factor for long-term biological complications in patients receiving implants along with concurrent GBR.