| Objective:This study retrospectively analyzed the effect of smoking on the peri-implant soft and hard tissues after implant restoration with simple taper-retained implants and investigated the influencing factors associated with the clinical outcome of smoking patients after implant restoration.Methods:Male patients who underwent implant restoration in the Department of Stomatology,Fourth Affiliated Hospital of Nanchang University from January 2017 to June 2019 and met the inclusion criteria were retrospectively analyzed and divided into smoking and non-smoking groups according to their smoking status,and the smoking group was subgrouped according to the initial vertical mucosal thickness of the proposed implant sites(thin gingival group: initial vertical mucosal thickness 3mm)and implant placement depth(Group A: placement depth ≤ 2 mm and Group B:placement depth > 2 mm)were subgrouped.A total of 37 male patients with 84 implants were included,18 in the smoking group(51 implants)and 19 in the non-smoking group(33 implants).Collection of full-mouth curved body radiographs taken immediately after implant surgery(T1),on the day the final restoration was completed(T2)and on the day of the final follow-up(T3),and the proximal and distal marginal bone heights of the implants were measured using Digimizer(V4.5.1)software and the peri-implant osseous value(GSV)was measured using image J software to evaluate the use of taper-retained implants in smokers versus non-smokers.Changes in marginal bone resorption and peri-implant bone loss after implant restoration with simple taper-retained implants were evaluated in smokers and nonsmokers.The prevalence of peri-implant disease and the survival of the implants were also analyzed by recording the modified plaque index(m PLI),modified bleeding index(m BLI)and probing depth(PD)at the last follow-up visit.The collected data were statistically analyzed by SPSS 24.0 software.Results:During the follow-up period,a total of 84 implants in 37 male patients were not loosened and dislodged during the bone healing period,with a 100.00% implant retention rate;98.04% and 100.00% of implants were retained in the smoking and non-smoking groups,respectively,after completion of the upper restoration.There was a significant difference between the m PLI,m BLI and PD in the smoking and non-smoking groups(P < 0.05),and the m PLI,m BLI and PD were higher in the smoking group than in the non-smoking group;peri-implant mucositis occurred in eight implants(9.64%)and peri-implantitis in eight implants(9.64%)during the observation period,and implant Peri-implant mucositis and peri-implantitis were observed in both smoking and non-smoking groups,but there was no significant difference in prevalence between the two groups(P > 0.05).The only statistically significant difference between the smoking and non-smoking groups in the implant MBL was the distal mid MBL in the T2-T1 period(P < 0.05),while there was no significant difference between the proximal mid MBL in the T2-T1 period,the proximal mid MBL in the T3-T1 period,and the proximal mid MBL in the T3-T2 period(P > 0.05);the peri-implant ashes in the smoking and non-smoking groups were statistically different(P < 0.05).There was no statistically significant difference in the peri-implant ashes between the smoking and non-smoking groups(P < 0.05),except for the change in apical GSV3 in the T3-T2 period,and the change in proximal-mid GSV,distal-mid GSV,apical GSV,and△GSV in the T2-T1,T3-T1,and T3-T2 periods(excluding apical GSV3)(P > 0.05).In the smoking group,patients in the smoking group were subgrouped according to the vertical mucosal thickness of the implant sites.In the T2-T1 period,the △MBL of implants in the thin gingival group was significantly different from that in the medium-thick gingival group and the thick gingival group,respectively(P < 0.05),and the △MBL in the thin gingival group was greater than that in the medium-thick gingival group and the thick gingival group,while there was no significant difference in the △MBL between the medium-thick gingival group and the thick gingival group(P > 0.05);in the T3-T2 period,the difference in implant △MBL between the thin gingival group and the thick gingival group was statistically significant(P < 0.05),while the differences between the thin gingival group and the medium-thick gingival group and between the medium-thick gingival group and the thick gingival group were not statistically significant(P > 0.05);however,in the T3-T1 period,the differences in implant △MBL between the three groups were not statistically significant(P > 0.05);m PLI,m BLI,PD,and implant △MBL were statistically significant(P > 0.05).m PLI,m BLI,PD,peri-implant disease prevalence,and △GSV in all three periods(T2-T1,T3-T1,and T3-T2)were not statistically different depending on the vertical mucosal thickness of the implant site(P > 0.05).In the smoking group,patients in the smoking group were subgrouped according to the depth of implant placement in the bone.m PLI,m BLI,PD,prevalence of peri-implant disease and changes in △GSV in three periods(T2-T1,T3-T1 and T3-T2)in group A and group B were not statistically different depending on the depth of implant placement in the bone.There was no statistically significant difference(P >0.05)depending on the depth of implant placement.However,the difference in△MBL between group A and group B was statistically significant(P < 0.05)in the T2-T1 and T3-T1 periods,and there was no statistical difference in the amount of change in △MBL in the T3-T2 period(P > 0.05).In the implant restoration satisfaction survey of 37 male patients in this study,satisfaction values of 91 to 100 points accounted for 18.92% of the total(22.22% in the smoking group and 15.79% in the non-smoking group),satisfaction values of 81 to 90 points accounted for 70.27% of the total(72.22% in the smoking group and68.42% in the non-smoking group),satisfaction values of 70 to 80 points accounted for 10.81%(5.56% in the smoking group and 15.79% in the non-smoking group),and there was no statistical difference in satisfaction between the smoking and non-smoking groups(P > 0.05).Conclusion:1.The use of simple taper-retained implants for implant restorations in smoking patients can achieve good clinical results,but smoking remains a high risk factor for increased incidence of peri-implant disease;2.When the vertical mucosal thickness of the implant site is <2 mm in smoking patients,there is an increased risk of bone resorption at the implant margin;3.When implant restorations are performed in smoking patients,the implant placement depth has no significant effect on the peri-implant soft and hard tissue changes. |
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