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Gene expression in peri-implant crevicular fluid of smokers and nonsmokers. 1. The early phase of osseointegration
Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden, and Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, and BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden.
Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, and BIOMATCELL, VINN Excellence Center of Biomaterials and Cell Therapy, Gothenburg, Sweden.
2017 (English)In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 19, no 4, p. 681-693Article in journal (Refereed) Published
Abstract [en]

Background: Smoking is a risk factor for dental implants. The mechanisms behind the impact of smoking on osseointegration are not fully understood.

Purpose: To investigate the initial molecular and clinical course of osseointegration of different titanium implants in smokers and nonsmokers.

Materials and Methods: Smoker (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.

Results: Early 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.

Conclusions: During 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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017. Vol. 19, no 4, p. 681-693
Keywords [en]
bone quality, bone quantity, gene expression, implant surface, osseointegration, pain, peri-implant crevicular fluid, RFA, smoking, cytokine, signal peptide, aged, chemistry, dental restoration, female, gene expression profiling, gingivitis, human, male, metabolism, middle aged, resonance frequency analysis, tooth implant, tooth implantation, Cytokines, Dental Implantation, Endosseous, Dental Implants, Dental Restoration Failure, Gingival Crevicular Fluid, Humans, Intercellular Signaling Peptides and Proteins
National Category
Dentistry
Identifiers
URN: urn:nbn:se:hj:diva-45104DOI: 10.1111/cid.12486ISI: 000407086300011PubMedID: 28470893Scopus ID: 2-s2.0-85018325602OAI: oai:DiVA.org:hj-45104DiVA, id: diva2:1330805
Available from: 2019-06-26 Created: 2019-06-26 Last updated: 2019-06-26Bibliographically approved

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