Share Hub — Smoking and Early Dental Implant Failure

In this episode, Dr. Narges Shojaei, a specialist in periodontics (perio), discusses the effect of tobacco on dental implants and oral surgeries, from the biological mechanisms of failure to practical protocols for managing the smoking patient.

She begins the discussion from a point that is often overlooked: that cigarette smoke, before any clinical event, affects the surface of the implant itself and its wettability, and this very thing disrupts the first stage of osseointegration. She then addresses the physiological mechanisms; the role of hypoxia, nicotine, and the disruption of the balance of bone remodeling and the immune response in the progression of peri-implantitis.

In the clinical part, Dr. Shojaei answers these questions: exactly how much higher is the risk of failure in smokers, why is the maxilla more vulnerable, and over what time window before and after surgery is quitting or reducing smoking genuinely effective. She also explains implant surface selection, surgical technique, and follow-up intervals and the monitoring of marginal bone loss in these patients.

In the final part, the discussion reaches substances that are less examined in this area: hookah, vape and electronic cigarettes, and cannabis; and why none of them is a safe alternative to cigarettes.

If you work with implants or have smoking patients, this episode both clarifies the mechanism and provides you with a practical framework for decision-making.