Smoking May Lead to Marginal Bone Loss Around Non-Submerged Implants During Bone Healing by Altering Salivary Microbiome: A Prospective StudyOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
This study asked how smoking affects the salivary microbiome and whether that influences marginal bone loss (MBL) around dental implants during healing. It was a prospective, controlled clinical study. Saliva was collected before implant surgery, and the microbiome was characterized by 16S ribosomal RNA gene amplicon sequencing. Each patient then received single-tooth implant surgery. Marginal bone loss around the implant was measured over a three-month bone-healing period and related to microbial features.
Who was studied?
The cohort was 20 periodontally healthy adults needing single-tooth replacement in the posterior mandible, split into smokers (n = 10) and non-smokers (n = 10). The study was conducted in China. All received non-submerged dental implants after oral clinical assessment. In total, 871,389 sequences were compared against the Human Oral Microbiome Database for bacterial identification.
What were the most important findings?
Smokers had lower salivary microbial diversity and richness, with a significant drop in uncultured species. The phyla Gracilibacteria and Saccharibacteria decreased in smokers. Several genera rose in smokers, including Streptococcus, Lachnoanaerobaculum, Stomatobaculum and Eubacterium, while Selenomonas and Catonella decreased. Porphyromonas gingivalis was significantly more abundant in smokers. Its abundance was positively related to the severity of marginal bone loss around implants during healing.
What are the greatest implications of this study?
The findings suggest smoking reshapes the salivary microbiome even in clinically healthy mouths, creating higher-risk bacterial communities. This shift, especially more Porphyromonas gingivalis, may promote bone loss around new implants. The authors frame this as a basis for personalized care and closer monitoring of smokers receiving implants. The study was small (10 per group) and observational over a short window, so it links but does not prove that smoking-driven microbial change causes implant bone loss. Larger and longer studies are needed.