Effect of smoking on immediate loaded implants placed by flapless computer guided surgery to support full arch fixed restoration inedentulous maxilla. One-year clinical and radiographic trial

Purpose: The aim of this prospective case-control clinical trial was to evaluate the effect of smoking on immediate loaded
implants placed by flapless computer guided surgery to support full arch fixed restoration in edentulous maxilla.
Materials and Methods: This study was conducted on10 male patients with completely edentulous maxillary ridge whom
divided into 2 groups.Study group comprised of 5 smoker patients who smoked > 10 cigarettes per day. The control group < br />comprised of 5 participants who had not smoke for at least 5 years and were case matched to study group. All patients received
6 implants in the maxillary ridge using computer guided surgery and flapless surgical protocol and the implants were immediately
loaded with fixed acrylic bridge.6months later, final ceramo-metal screw-retained prosthesis was delivered. Clinical (plaque
scores, gingival scores, pocket depth, implant stability,width of keratinized mucosa) and radiographic outcomes (crestal bone
loss) were measured at implant loading, 6 and 12 months later.
Results: Implant survival rate was 93.3 % and 80 % for non-smoker and smoker groups with significant difference between
groups. At 6 and 12 months, smoker group recorded significant higher plaque and gingival scores, pocket depth, and crestal bone
loss than non-smoker groups. At 6 months only, smoker group recorded significant higher implant stability than non-smoker
groups, however the difference disappeared after 12 months. No difference in width of keratinized mucosa was observed
between groups.
Conclusion:Within the limits of this study, smoker patients were associated with worsen clinical and radiographic outcomes
of immediate loaded implants placed by flapless computer guided surgery to support full arch fixed restoration in edentulous
maxilla compared to non-smoker patients.