期刊
CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH
卷 19, 期 4, 页码 681-693出版社
WILEY
DOI: 10.1111/cid.12486
关键词
bone quantity; bone quality; gene expression; implant surface; osseointegration; pain; peri-implant crevicular fluid; RFA; smoking
资金
- Medical Research Council of Southeast Sweden (FORSS)
- Jonkoping County Council
- Jonkoping (FUTURUM)
- BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy
- Vastra Gotaland Region
- Swedish Research Council [K2015-52X-09495-28-4]
- ALF/LUA Research Grant [ALFGBG-448851]
- IngaBritt and Arne Lundberg Foundation
- Vilhelm and Martina Lundgren Vetenskapsfond
- Area of Advance Materials of Chalmers and GU Biomaterials within the Strategic Research Area initiative
BackgroundSmoking is a risk factor for dental implants. The mechanisms behind the impact of smoking on osseointegration are not fully understood. PurposeTo investigate the initial molecular and clinical course of osseointegration of different titanium implants in smokers and nonsmokers. Materials and MethodsSmoker (n=16) and nonsmoker (n=16) patients were included. Each patient received three implant types: machined, oxidized and laser-modified surfaces. After 1, 7, 14, and 28 days, the peri-implant crevicular fluid (PICF) was sampled for gene expression analysis of selected factors involved in early processes of osseointegration. Furthermore, pain-score (VAS), resonance frequency analysis (RFA) and baseline clinical assessments were performed. ResultsEarly failure of osseointegration, associated with a high and sustained perception of pain, was encountered in 3/32 patients. In general, high pain scores were reported during the first days after implantation, irrespective to smoking habit, which correlated to high levels of pro-inflammatory cytokines during the first days after implantation. Higher ISQ values were found in smokers compared to nonsmokers. In smokers exclusively, ISQ values correlated to harder and less atrophic bone quality and quantity, respectively. Smokers displayed a higher expression of osteocalcin (OC), but later peak and lower expression of bone morphogenetic protein (BMP-2) (at 7 days) compared to nonsmokers. In comparison to machined implants, surface-modified implants were associated with higher expression of alkaline phosphatase (ALP) and cathepsin K (CatK) at 28 days in nonsmokers. ConclusionsDuring the early phase of osseointegration, postoperative pain is linked to the inflammatory cell response and, may tentatively serve as an indicator of biological complication and implant loss. The present study suggests that smokers have an altered bone composition and (ultra)structure based on the observations that ISQ values are higher and correlate to recipient bone quality and quantity in smokers.
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