مقاله انگلیسی رایگان در مورد مطالعه کوهورت گذشته‌نگر برای مقایسه‌ی افراد سیگاری و غیر‌سیگاری – J-STAGE 2018

Abstract

The aim of this study was to compare the 5-year outcome of full-arch mandibular fixed prosthetic rehabilitation using the All-on-4 concept in smoking and nonsmoking patients. This retrospective cohort study included 200 patients (n = 100 smokers, n = 100 nonsmokers), 119 women and 81 men, with an average age of 53.7 years, rehabilitated in immediate function with 800 implants. Implant cumulative survival rate estimation (Kaplan-Meier with log-rank test) and marginal bone resorption (MBR) at 5 years (Mann-Whitney test) were compared between both groups. Multivariable analysis was used to investigate potential risk indicators for MBR ≥ 2.8 mm at 5 years. Nine patients (4.5%) were lost to follow-up. Four patients lost eight implants, specifically one nonsmoking patient (n = 1 implant) and three smoking patients (n = 7 implants), resulting in a cumulative survival rate estimation of 99.0% and 96.9% for nonsmokers and smokers, respectively (P = 0.296). The average (standard deviation) MBR at 5 years was 1.68 mm (0.76 mm) and 1.98 mm (1.02 mm) for nonsmokers and smokers, respectively (P = 0.045). Smoking (odds ratio = 2.92) was the only risk indicator significantly associated with MBR ≥ 2.8 mm in multivariable analysis. Smoking should not be an absolute contraindication for rehabilitation of the edentulous mandible through the All-on-4 concept; however, smoking habits were significantly associated with MBR ≥ 2.8 mm.

Introduction

Smoking has long been causally associated with several cancers, heart disease, and chronic obstructive pulmonary disease and represents the leading cause of premature death and morbidity in the Western world (U.S. Department of Health and Human Services. The health consequences of smoking: a report of the surgeon general. 2004; 1). Cigarette smoking was previously reported to have a detrimental effect on early bone tissue response around dental implants, with marginal bone loss, gaps, and fibrous tissue surrounding the implants retrieved from smokers, together with a significant decrease in bone to implant contact percentage compared to nonsmokers (2).