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Original Article
- Association between smoking and the risk of dental implant failure in Korean adults: a nationwide cohort study
- Yu-Rin Kim, Minkook Son, Hyeon Ji Kim, Seon-Rye Kim
- Epidemiol Health. 2026;48:e2026002. Published online January 14, 2026
- DOI: https://doi.org/10.4178/epih.e2026002
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AbstractOBJECTIVES
We evaluated the associations of smoking status, intensity, duration, and cumulative exposure with the risk of dental implant failure in Korean adults.METHODSThis retrospective cohort study utilized the National Health Insurance Service–Health Screening Cohort (2016–2019). Overall, 23,573 individuals who had completed the dental implant process were included. Smoking status was categorized as non-smoker, ex-smoker, or current smoker. Smoking intensity, duration, and cumulative exposure were classified using standardized thresholds (>10 cigarettes per day, >10 years, and >10 pack-years). Implant failure was defined as reimplantation or removal. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, clinical, and behavioral covariates.RESULTSDuring follow-up, 605 implant failures occurred: 344 in non-smokers, 182 in ex-smokers, and 79 in current smokers. The corresponding incidence rates per 1,000 person-years were 11.56, 16.54, and 22.33, respectively. Current smoking was significantly associated with higher implant failure risk (adjusted HR, 1.59; 95% CI, 1.20 to 2.09), while ex-smokers displayed a non-significant increase (adjusted HR, 1.16; 95% CI, 0.94 to 1.45). A dose–response relationship was observed: smoking more than 10 cigarettes per day, smoking for more than 10 years, or exceeding 10 pack-years was associated with significantly increased risk.CONCLUSIONSSmoking is a significant, dose–dependent risk factor for dental implant failure in Korean adults. Current smokers have the highest risk; smoking cessation may reduce adverse outcomes. These findings emphasize the importance of detailed smoking assessments and cessation counseling in implant care and public health strategies. -
SummaryKorean summary
본 연구는 치아 임플란트를 시행한 성인들을 대상으로 흡연 상태(현재, 과거, 비흡연)와 흡연 강도, 기간, 누적 노출량에 따른 임플란트 실패 위험의 차이를 분석하였다. 분석 결과, 비흡연자에 비하여 현재 흡연자, 하루 10개피 이상 흡연자, 10년 이상 장기 흡연자, 10갑년 이상 누적 흡연자에서 임플란트 실패 위험이 유의하게 높았다. 특히, 여성의 경우 흡연이 임플란트 실패에 미치는 영향이 남성보다 크게 나타났다. 반면, 과거흡연자는 통계적으로 유의한 연관성을 보이지 않았다. 이러한 결과는 구강건강 증진과 임플란트의 성공적 예후를 위해 흡연자의 금연지도가 필수적임을 시사한다.Key Message
This study examined differences in implant failure risk according to smoking status (current, former, never) and smoking intensity, duration, and cumulative exposure among adults who underwent dental implant placement. Compared with never-smokers, the risk of implant failure was significantly higher in current smokers, those who smoked ≥10 cigarettes/day, long-term smokers (≥10 years), and individuals with ≥10 pack-years of cumulative smoking exposure. Notably, the adverse impact of smoking on implant failure was greater in women than in men. In contrast, former smoking was not statistically associated with implant failure. These findings underscore the need for structured smoking-cessation counseling to improve oral health and optimize implant prognosis.
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