Tobacco consumption induces alveolar crest height loss independently of mandibular bone mass and bone density




To investigate the relationship of tobacco consumption with alveolar crest height (ACH) loss and mandibular bone mass estimated by digital panoramic radiography and cone-beam computed tomography (CBCT).

Material and methods

We studied 315 patients (43.2% [= 136] men and 56.8% [= 179] women) with mean age of 36.6 ± 5.3 (range 21–30 years (16.2%), range 31–46 years (83.8%); 9% (= 71) were smokers (>10 cig./day). A mean of 13.0 ± 2.0 mandibular teeth were present: 37.5% of patients had 6–12 teeth and 62.5% 13–16 teeth. We analyzed 315 digital panoramic radiographs (2D) and calculated the ACH, mandibular cortical width, and basal and alveolar bone gray level values. ACH and bone density were also measured on CBCT (3D) in the 110 patients scheduled for implantation.


In the univariate analysis, ACH loss was greater in older patients (= 0.012) and in those with fewer mandibular teeth (< 0.001) and showed a relationship with tobacco consumption that was close to significant (= 0.079). In the multivariate analysis, the number of mandibular teeth (< 0.001) and tobacco consumption (= 0.048) were significantly associated with ACH. Alveolar and basal bone densities were associated, respectively, with number of mandibular teeth (= 0.012) and cortical width (= 0.030).


In a Caucasian population aged 21–46 years, tobacco consumption was significantly associated with ACH loss. However, ACH loss showed no significant relationship with mandibular bone mass estimated either as mandibular cortical width index or bone density on digital panoramic radiographs or as bone density on CBCT. ACH loss was a local event independent of mandibular bone mass status.