Objective:
Oral implant loss has been recognized to be associated with smoking. Nicotine is affected by peri-implant soft tissue with vasoconstriction and impaired cellular healing response. However, a gap between preclinical and clinical research outcomes was observed. A cross-sectional, nationwide survey was conducted to examine the relationship between tobacco smoking and oral diseases among the Japanese population.

Methods:
Questionnaire survey sheets were sent to 489 designated facilities by postal mail, and in all, 251 (50.4%) facilities responded. Among these, 246 were valid responses. The following demographic items were corrected: number of implants placed, duration of observation period after implantation, smoking habits, number of cigarettes, smoking duration, drinking habits, diabetes mellitus morbidity, and number of implant failures for those who underwent implantation between January 1, 2012 and December 31, 2012. Pack-years in implant loss were evaluated in three groups: at ≤12 months (early loss group), ≤120 months (late loss group) and >120 months of implant loss (non-implant loss group).

Results:
During the survey period, 1,966 patients were analyzed. The odds ratio for implant failure was 2.20 (95%CI: 1.34–3.63) for current smokers in a selected age group (≤20 years). The pack-years were higher in the late implant loss group (35.7 ± 18.4) than those in the non-implant loss group (26.1 ± 18.1). The result indicated that a higher number of pack-years was associated with late implant loss. However, the number of pack-years was not associated with early implant loss.

Conclusions:
This cross-sectional survey conducted in Japan suggested that smoking is significantly associated with implant failure. Irrespective of the duration of smoking exposure, smoking habit was associated with early implant loss.