Smoking may affect the alveolar process dimensions and radiographic bone density in maxillary extraction sites: A prospective study in humans

Purpose: Loss of ridge width and height typically occur after tooth extraction. This study aimed to investigate whether smoking would effect alveolar ridge remodeling after tooth extraction. Materials and Methods: Twenty-one individuals (11 nonsmokers, 10 smokers) requiring a nonmolar extraction in the tipper jaw were selected. Radiographs were taken 7 and 180 days after surgery, and the following parameters obtained: alveolar process height (AH), alveolar process width (AW), radiographic bone density in the postextraction socket (BDS), and in the pre-existing bone apically (BDPB). Results: Six months after surgery, intragroup, analysis showed that both groups presented a significant reduction in AH, while only smokers had a significant reduction in AW, BDS, and BDPB (P < .05). Furthermore, intergroup analysis showed that smokers presented lower BDS (91.45 pixels +/- 26.62 and 59.53 pixels +/- 19.99, for nonsmokers and smokers, respectively; P = .006) and continued to present lower BDPB (129-34 pixels +/- 42.10 and 89.29 pixels +/- 29.96, for nonsmokers and smokers, respectively; P = .023). Additionally, smokers presented a tendency for lower AH and AW than nonsmokers, but this was not statistically significant. Conclusion: Within the limits of the present study, smoking may lead to a more significant dimensional reduction of the residual alveolar ridge and postpone postextraction socket heating. (c) 2006 American Association of Oral and Maxillofacial Surgeons.