Association Between Smoking and Vertical Post-extraction Alveolar Ridge Resorption: a Randomized Controlled Trial

Post-extraction bone resorption causes a significant reduction in the vertical and horizontal dimensions of the alveolar ridge.Over the years, various socket preservation methods have been adopted to minimize bone loss.However, it has been demonstrated that multiple local and systemic factors influence the resorption process.Tobacco smoking is one of the systemic factors thought to influence the resorption process negatively.This randomized clinical trial aimed to assess the effect of smoking on vertical alveolar bone resorption during the first three months after single tooth extraction, with or without an SP procedure.Materials and methods: The research involved 80 patients who required a single-tooth extraction and underwent either a socket preservation procedure or unassisted socket healing.The heights of the socket plates were measured twice, first after the intervention and then after 3 months, using cone-beam computed tomography.Results: A statistically significant difference was found only in the second experimental group between smokers and non-smokers ( = 7.2, p = 0.007).No statistically significant difference was observed in the vertical resorption of both plates between smokers and non-smokers after 3 months.Discussion: Although the harmful effects of smoking on bone healing and resorption have been welldocumented, the results of this study did not present any evidence that smoking affects the vertical postextraction loss of the alveolar crest for 3 months after the extraction.Conclusion: More long-term preclinical and clinical studies are necessary to assess the enduring effects of smoking (and its intensity) on postextraction resorption, if any.Additionally, its influence on both bone quantity and quality should be examined using suitable radiological, histological, and histomorphometric methods.