An In Vivo Comprehensive Assessment of Changing Crestal Bone Levels By IP-CB Distance Around Implants Placed in the Anterior Maxillary Region in Patients with and Without Smoking Habit- A Cone Beam Computed Tomography-Based Original Research Study

Abstract

Aim: This study aims to assess the change of crestal bone levels by the IP-CB distance around implants placed in the anterior maxillary region in patients with and without smoking habits.

Materials and Methods: A study involving 40 individuals aged 25 to 50 who preferred implant placement. Exclusion criteria included mental instability, systemic diseases. Informed consent was obtained from all participants. Cone beam computed tomography (CBCT) was used for implant placement, and patients rinsed with chlorhexidine mouthwash to reduce infection risk. On surgery day, an infraorbital nerve block was administered for implant surgery. The experienced operator performed an incision, ostectomy, and implant placement using a consistent implant kit. After surgery, the flap was sutured. A healing abutment was placed after a two-month healing period, followed by the implant-supported prosthesis fitting in the third month of surgery. The study compared 20 non-smokers (Group 1) to 20 smokers (Group 2), by measuring distances from the implant platform to the crestal bone level at three, six, and nine months to analyze smoking's impact on implant success.

Statistical Analysis and Results: This study caught up 40 individuals, aged 25 to 50, with a missing right maxillary central incisor, comprising 21 males and 19 females. All 40 patients preferred implant placement, and a comprehensive cone beam computed tomography (CBCT) was conducted pre-surgery. Patients rinsed with chlorhexidine mouthwash to reduce infection risk, and on surgery day, an infraorbital nerve block was administered for comfort before implant placement. After two months of healing, a healing abutment was added, and an implant-supported prosthesis was fitted by the third month. Patients were divided into two groups: 20 non-smokers and 20 smokers. CBCT measurements from the implant platform to the crestal bone level were taken at three, six, and nine months. Results indicated that normal ranges for non-smokers decreased from 17 to 15 patients over time, while smokers showed a drop from 15 to 13. A one-way ANOVA was utilized to analyze the results across both groups.

Conclusion: This study concluded that smokers experienced a moderate yet significant increase in crestal bone loss compared to non-smokers, highlighting the negative effects of smoking on oral health. Smokers exhibited greater marginal bone loss (MBL), increasing the risk of implant failure in the maxilla. Future research should aim to further explore this critical issue to enhance clinical practices and patient outcomes.