Association between cumulative smoking exposure, span since smoking cessation, and peri-implantitis: a cross-sectional study.

Objectives: To investigate the association of cumulative smoking exposure and span since smoking cessation with the occurrence of peri-implantitis.

Methods: A sample of 350 individuals aged ≥ 35 years, with the presence of at least one osseointegrated implant functioning for > 5 years, were enrolled in the study. According to smoking habits, participants were categorized into 3 groups: non-smokers (NS; n = 212), former smokers (FC; n = 66), and current smokers (CS; n = 72). Complete peri-implant and periodontal examinations were evaluated. Associations between the occurrence of peri-implantitis and smoking habits, as well as potential confounders, were evaluated through univariate and multivariate analyses.

Results: The occurrence of peri-implantitis in the NS, FS, and CS groups was 18.2%, 19.7%, and 30.5%, respectively. A high prevalence of the overall number of cases with periodontitis (54.2%) was observed in the CS group when compared to the FS and NS groups. After adjusting for confounders, the odds ratio (OR) for the occurrence of peri-implantitis was 2.63 (1.39-6.77; p < 0.001) for CS compared to NS. There was a significant dose-response relationship between pack/year of smoking and the occurrence of peri-implantitis, as well as a significant decrease in the risk as the years of smoking cessation increased.

Conclusions: The occurrence of peri-implantitis among CS was high. The cumulative smoking exposure in an incremental manner and the shorter smoking cessation span was directly associated with a higher risk for peri-implantitis.

Clinical Relevance: Educational and preventive strategies in general health services must attempt to reduce the adverse effects of cumulative smoking exposure and to explore the beneficial effects of smoking cessation on peri-implant status.