Objective:To evaluate the short-term clinical effects of smoking on maxillary sinus augmentation with dental implant. Methods:Nine hundred and eighty-one patients (1 911 implants) who were treated with dental implantation for maxillary posterior tooth loss were followed up. Among them, 28 patients (71 implants) who were treated with maxillary sinus augmentation and followed-up effectively were analyzed and divided into two groups according to smoking condition:the smoking group (14 patients treated with 27 implants) and the non-smoking group (14 patients treated with 44 implants). The average follow-up time was (16±11) months.The survival rate of implants, marginal bone loss (MBL) and the changes of bone substitutes in sinus floor of the two groups were recorded and compared at the day of surgery(T1), 6 months (T2), and follow-up after functional loading (T3).Results:Among the 981 patients, the implant survival rate in the smoking group (91.9%) treated with maxillary sinus augmentation was statistically significantly lower than that of non-smoking the group (99%) (P<0.05). Twenty-eight patients who were treated with maxillary sinus augmentation and followed-up effectively were found no loss of implants during the observation period. Compared with T1, MBL of the both groups showed reduction in the buccal and palatal side, mesial and distal side at T2 (all P<0.05). But there was no statistically significant difference in MBL of 4 directions between the two groups. At T3, MBL of the both groups showed significant reduction in the buccal and palatal side, mesial and distal side compared with baseline (T1). MBL in palatal side of smoking group[(-0.78±0.91) mm] was more obviously than that of non-smoking group[(-0.34±0.59) mm] (P<0.05). And MBL in buccal, mesial and distal side of the both groups showed no statistical difference. Compared with T1, the obvious bone substitutes absorption of the maxillary sinus was found in the both groups at T2 and T3(all P<0.05), with no statistical difference between the two groups. In the both groups, the density of bone powder implanted into sinus floor increased at T2, and decreased at T3, which was still higher compared to baseline(T1). Conclusions:In the patients with short-term functional load after maxillary sinus augmentation with dental implant, the survival rate of implant in the smoking group is significantly lower than that in the non-smoking group. And the MBL of palatal side largely exposed to smoke in smoking group is more obvious compared with non-smoking group. To some extent, smoking is a risk factor for maxillary sinus augmentation with dental implant, which may be closely related to the decrease of implant survival rate and the increase of marginal bone loss.
 LEE J,TANEJA V,VASSALLO R.Cigarette smoking and inflammation:cellular and molecular mechanisms[J].J Dent Res,2012,91(2):142-149.
 WHEELER S L,HOLMES R E,CALHOUN C J.Six-year clinical and histologic study of sinus-lift grafts[J].Int J Oral Maxillofac Implants,1996,11(1):26-34.
 CHAMBRONE L,PRESHAW P M, FERREIRA J D,et al.Effects of tobacco smoking on the survival rate of dental implants placed in areas of maxillary sinus floor augmentation:a systematic review[J].Clin Oral Implants Res,2014,25(4):408-416.
 LEVIN L.Smoking may decrease the survival rate of dental implants placed in areas of maxillary sinus floor augmentation[J].J Evid Based Dent Pract,2014,14(4):183-184.
 FELDMAN C,ANDERSON R.Cigarette smoking and mechanisms of susceptibility to infections of the respiratory tract and other organ systems[J].J Infect,2013,67(3):169-184.
 GHASEMI S,FOTOUHI A,MOSLEMI N,et al.Intra-and postoperative complications of lateral maxillary sinus augmentationin smokers vs nonsmokers:a systematic review and meta-analysis[J].Int J Oral Maxillofac Implants,2017,32(4):759-767.
 GALINDO-MORENO P,FERNANDEZ-JIMENEZ A,AVILA-ORTIZ G,et al.Marginal bone loss around implants placed in maxillary native bone or grafted sinuses:a retrospective cohort study[J].Clin Oral Implants Res,2014,25(3):378-384.
 SAKKA S,COULTHARD P.Bone quality:a reality for the process of osseointegration[J].Implant Dent,2009,18(6):480-485.
 FRANCESCHETTI G,FARINA R,STACCHI C,et al.Radiographic outcomes of transcrestal sinus floor elevation performed with a minimally invasive technique in smoker and non-smoker patients[J].Clin Oral Implants Res,2014,25(4):493-499.
 孔祥槐, 胡圣望.上颌后牙种植术与上颌窦的关系探讨[J].现代医学,2011,39(3):339-340.
 CRIVELLARO V R,ZIELAK J C,DELIBERADOR T M,et al.Pneumatization within a maxillary sinus graft:a case report[J].Int J Implant Dent,2016,2(1):3.
 MOHLHENRICH S C,HEUSSEN N,ELVERS D,et al.Compensating for poor primary implant stability in different bone densities by varying implant geometry:a laboratory study[J].Int J Oral Maxillofac Surg,2015,44(12):1514-1520.
 PASQUALI P J,TEIXEIRA M L,de OLIVEIRA T A,et al.Maxillary sinus augmentation combining bio-oss with the bone marrow aspirate concentrate:a histomorphometric study in humans[J].Int J Biomater,2015,2015:121286.
 BASSI A P,PIOTO R,FAVERANI L P,et al.Maxillary sinus lift without grafting, and simultaneous implant placement:a prospective clinical study with a 51-month follow-up[J].Int J Oral Maxillofac Surg,2015,44(7):902-907.