Implants · single question
Which of the following factors would have the greatest impact on a proposed all-on-X (full arch implant) treatment plan for a 54-year-old smoker?
Show answer and explanation
Correct answer: D. Smoking history
Smoking is one of the most significant modifiable risk factors for implant failure. Nicotine impairs angiogenesis, reduces blood supply to the bone, impairs immune function, and delays healing — all of which dramatically increase the risk of implant osseointegration failure. A 30 pack-year smoking history is a major red flag that directly impacts the prognosis of any implant treatment plan, particularly a full-arch all-on-X treatment.
- A. INCORRECT. Esthetics is an outcome goal — it does not determine the feasibility or prognosis of the treatment plan in the way smoking does.
- B. INCORRECT. Medical history is important (e.g., uncontrolled diabetes, anticoagulation) but the patient's medical history as stated (hypertension managed with medication) does not have as great an impact as active smoking.
- C. INCORRECT. Periodontal status is important for implant prognosis, but the patient's teeth will be extracted — the periodontium itself is less relevant than the bone healing environment, which is directly impaired by smoking.
- D. CORRECT. Smoking is the single greatest MODIFIABLE risk factor for implant failure. A 30 pack-year history with current smoking significantly compromises osseointegration, wound healing, and long-term implant success.