Smoking May Affect the Alveolar Process Dimensions and Radiographic Bone Density in Maxillary Extraction Sites: A Prospective Study in Humans

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. Twenty-one individuals (11 nonsmokers, 10 smokers) requiring a nonmolar extraction in the upper 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). 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. 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 healing.