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Steyer E, Theisen K, Hulla H, Ubaidha Maheen C, Sokolowski A, Lorenzoni M. Eleven- to fifteen-year outcome for two-piece implants with an internal tube-in-tube connection: a cross-sectional analysis of 245 implants. Oral Maxillofac Surg 2024; 28:859-867. [PMID: 38315402 DOI: 10.1007/s10006-024-01215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this retrospective study was to evaluate the outcomes of a two-piece implant system with a tube-in-tube internal connection after up to 15 years of clinical use. MATERIAL AND METHODS A retrospective follow-up examination of patients treated with internal tube-in-tube implants between 2003 and 2006 was conducted. The implant survival rates, peri-implant conditions (marginal bone loss, bleeding on probing, plaque index, probing depth), and technical complications were determined. RESULTS In total, 312 dental implants were placed in 152 patients. Of the original 152 patients enrolled, 245 implants in 112 patients were available for a follow-up evaluation after 11 to 15 years (mean observation time, 12.9 ± 1.1 years). The overall implant survival rate was 93.9%. Outcomes for MBL (1.49 ± 1.23 mm), PI (24.3 ± 22.2%), BOP (18.3 ± 28.7%), and PD (2.74 ± 1.21 mm) were observed. Selected parameters (time after implant surgery, smoking habits, bone augmentation (GBR)) showed an influence on MBL and PD. CONCLUSIONS The internal tube-in-tube implant system showed favorable long-term results. The correlation of MBL and PD with the patient-specific factor smoking habit is in accordance with other studies. CLINICAL RELEVANCE Camlog Root-Line implants with a tube-in-tube implant-abutment connection and a 1.6-mm polished neck configuration have demonstrated favorable long-term outcomes in daily clinical practice. However, it is important to note that these implants are no longer available on the market.
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Affiliation(s)
- Elisabeth Steyer
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Kerstin Theisen
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria.
| | - Helfried Hulla
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
- Private Practice Straß, Graz, Austria
| | - Ceeneena Ubaidha Maheen
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Alwin Sokolowski
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Martin Lorenzoni
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
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Paljevic E, Brekalo Prso I, Hrstic JV, Pezelj-Ribaric S, Persic Bukmir R. Impact of Smoking on the Healing of Apical Periodontitis after Nonsurgical Endodontic Treatment. Eur J Dent 2024; 18:124-130. [PMID: 36977477 PMCID: PMC10959606 DOI: 10.1055/s-0043-1761451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES The aim of this prospective study was to compare the healing of periapical bone between smokers and nonsmokers after root canal therapy. The effects of duration and intensity of smoking on the healing rate of apical periodontitis were analyzed. MATERIALS AND METHODS Fifty-five smokers were included in this study. The control group consisted of healthy nonsmokers who matched the smoker group in age and sex. Only teeth with a favorable periodontal prognosis and adequate coronal restoration were included in the study. The periapical status of treated teeth was assessed using the periapical index system at follow-ups after 6 and 12 months. STATISTICAL ANALYSIS The chi-squared test and Mann-Whitney U test were used to assess the changes in periapical index score at baseline and in subsequent time intervals between the two groups examining dichotomized and ordinal data, respectively. Multivariate logistic regression analysis was used to test the association of independent variables age, gender, tooth type, arch type, and smoking index with the outcome variable. The outcome variable was set as the presence versus absence of apical periodontitis. RESULTS The analysis at 12-month follow-up revealed a significantly higher healing rate in control group than in smokers (90.9 vs. 58.2; χ2 = 13.846; p < 0.001). Smokers had significantly higher periapical index scores than the control group (p = 0.024). The multivariate logistic regression analysis demonstrated that an increase in the value of the smoking index significantly increases the risk of apical periodontitis persistence (odds ratio [OR] =7.66; 95% confidence interval [CI]: 2.51-23.28; p < 0.001) for smoking index < 400 and (OR = 9.65; 95% CI: 1.45-64.14; p = 0.019) for smoking index 400 to 799. CONCLUSION The results from this study show a lower rate of apical periodontitis healing in a group of smokers at 1-year follow-up. Delayed periapical healing seems to be associated with the cigarette smoking exposure.
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Affiliation(s)
- Ema Paljevic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ivana Brekalo Prso
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
- Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Jelena Vidas Hrstic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Sonja Pezelj-Ribaric
- Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Oral Medicine, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Romana Persic Bukmir
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
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Wach T, Hadrowicz P, Trybek G, Michcik A, Kozakiewicz M. Is Corticalization in Radiographs Related to a Higher Risk of Bone Loss around Dental Implants in Smoking Patients? A 5-Year Observation of Radiograph Bone-Texture Changes. J Clin Med 2023; 12:5351. [PMID: 37629393 PMCID: PMC10456057 DOI: 10.3390/jcm12165351] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/20/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Currently, the topic of dental implants is widely researched. However, still compromising are the factors that can affect implant loss as a consequence of marginal bone loss. One of the factors is smoking, which has a devastating effect on human health and bone structure. Oral health and jaw condition are also negatively affected by smoking. The aim of this study was to evaluate the peri-implant jawbone corticalization phenomenon in tobacco smokers. METHODS A total of 2196 samples from 768 patients with an implant in the neck area were checked, and texture features were analyzed. The corticalization phenomenon was investigated. All analyses were performed in MaZda Software. The influence of corticalization was investigated as a factor on bone structure near the implant neck. The statistical analysis included a feature distribution evaluation, mean (t-test) or median (W-test) comparison, analysis of regression and one-way analysis of variance or Kruskal-Wallis test as no normal distribution or between-group variance was indicated for the significant differences in the investigated groups. Detected differences or relationships were assumed to be statistically significant when p < 0.05. RESULTS The research revealed that MBL was correlated with smoking after 5 years (0.42 mm ± 1.32 mm 0 mm ± 1.25 mm), the Corticalization Index was higher in the smoker group on the day of surgery, and it became higher after 5y of observation (185.98 ± 90.8 and 243.17 ± 155.47). The implant-loss frequency was higher in the group of smokers, too, compared to non-smokers (6.74% and 2.87%). The higher the torque value during the implant placement, the higher the Corticalization Phenomenon Index. CONCLUSIONS The research revealed a correlation between smoking and changes in bone structure in radio textures near the implants. The corticalization phenomenon is important, may be detected immediately after implant placement and may be one of the indicators of the implant success rate.
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Affiliation(s)
- Tomasz Wach
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland;
| | - Piotr Hadrowicz
- Department of Otolaryngology, Hospital in Sosnowiec, Zegadłowicza 3, 41-200 Sosnowiec, Poland;
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
- 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wroclaw, Poland
| | - Adam Michcik
- Department of Maxillofacial Surgery, Medical University of Gdansk, 80-210 Gdańsk, Poland;
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland;
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Kanmaz M, Kanmaz B, Buduneli N. Periodontal treatment outcomes in smokers: A narrative review. Tob Induc Dis 2021; 19:77. [PMID: 34707470 PMCID: PMC8494073 DOI: 10.18332/tid/142106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/19/2021] [Accepted: 09/09/2021] [Indexed: 01/01/2023] Open
Abstract
Smoking is considered as the major environmental risk factor for periodontal diseases. Smokers have a higher risk for severe periodontitis with more periodontal tissue destruction, more gingival recession, and more susceptibility for tooth loss. The aim of this narrative review is to provide up-to-date evidence on the clinical outcomes of periodontal treatment in smokers. Electronic databases were searched for studies that compare the clinical outcomes in smokers and non-smokers following non-surgical and surgical periodontal treatment modalities and also during the supportive periodontal treatment. Clinical studies published before May 2021 were included in the review. Smokers have a higher risk for recurrence of periodontal disease and the response to non-surgical as well as surgical periodontal treatment is not as good as that of non-smokers. Moreover, there is a dose-response effect in the adverse effects of smoking on periodontal health. Compared to non-smokers, smoker patients with periodontitis tend to respond less favorably to non-surgical and surgical periodontal treatment, and exhibit recurrence more frequently during supportive periodontal treatment. Along with the periodontal treatment, smokers may be encouraged to quit. Long follow-up and the communication between the dentist and the patient give a great opportunity for such counseling.
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Affiliation(s)
- Mehmet Kanmaz
- Department of Periodontology, Faculty of Dentistry, Izmir Tınaztepe University, Izmir, Turkey
| | - Burcu Kanmaz
- Department of Periodontology, Faculty of Dentistry, Izmir University of Democracy, Izmir, Turkey
| | - Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
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Castellanos-Cosano L, Carrasco-García A, Corcuera-Flores JR, Silvestre-Rangil J, Torres-Lagares D, Machuca-Portillo G. An evaluation of peri-implant marginal bone loss according to implant type, surgical technique and prosthetic rehabilitation: a retrospective multicentre and cross-sectional cohort study. Odontology 2021; 109:649-660. [PMID: 33496913 DOI: 10.1007/s10266-020-00587-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/21/2020] [Indexed: 02/01/2023]
Abstract
To evaluate implant loss (IL) and marginal bone loss (MBL); follow-up period of up to 10 years after prosthetic loading. Retrospective multi-centre cross-sectional cohort study. Double analysis: (1) all the implants (n = 456) were analysed; (2) to allow for possible cluster error, one implant per patient (n = 143) was selected randomly. Statistical analysis: Spearman's correlation coefficient; Kruskal-Wallis (post-hoc U-Mann-Whitney); Chi-square (post-hoc Haberman). (1) Analysing all the implants (456): IL was observed in patients with past periodontitis (6 vs. 2.2%, p < 0.05), short implants (12 vs. 2.8%, p < 0.001) and when using regenerative surgery (11.3 vs. 2.9%, p < 0.001); greater MBL was observed among smokers (0.39 ± 0.52 vs. 0.2 ± 0.29, p < 0.01), maxillary implants (0.28 ± 0.37 vs. 0.1 ± 0.17, p < 0.0001), anterior region implants (0.32 ± 0.36 vs. 0.21 ± 0.33, p < 0.001), external connection implants (0.2 ± 0.29 vs. 0.63 ± 0.59, p < 0.0001), and 2-3 years after loading (p < 0.0001). (2) analysing the cluster (143): IL was observed in smokers (18.8 vs. 3.5%, p < 0.05), splinted fixed crowns (12.9%, p < 0.01), short implants (22.2 vs. 4.0%, p < 0.01) and when using regenerative surgery (19.2 vs. 3.4%, p < 0.01); greater MBL was observed in maxillary implants (0.25 ± 0.35 vs. 0.11 ± 0.18, p < 0.05), in the anterior region (p < 0.05), in the first 3 years (p < 0.01), in external connection implants (0.72 ± 0.71 vs. 0.19 ± 0.26, p < 0.01) and in short implants (0.38 ± 0.31 vs. 0.2 ± 0.32, p < 0.05). There is greater risk in smokers, patients with past periodontal disease, external connection implants, the use of short implants and when regenerative techniques are used. To prevent MBL and IL, implantologists should be very meticulous in indicating implants in patients affected by these host factors.
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Affiliation(s)
| | | | | | - Javier Silvestre-Rangil
- Department of Stomatology, Stomatology and Oral Surgery, Dr. Peset University Hospital, University of Valencia, Valencia, Spain
| | - Daniel Torres-Lagares
- Professor and Chairman of Special Care Dentistry, School of Dentistry, University of Seville, C/Avicena S/N, 41009, Seville, Spain
| | - Guillermo Machuca-Portillo
- Professor and Chairman of Special Care Dentistry, School of Dentistry, University of Seville, C/Avicena S/N, 41009, Seville, Spain.
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Mumcu E, Dayan SÇ. Effect of Smoking and Locations of Dental Implants on Peri-Implant Parameters: 3-Year Follow-Up. Med Sci Monit 2019; 25:6104-6109. [PMID: 31414668 PMCID: PMC6707095 DOI: 10.12659/msm.916613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Smoking may be a risk factor for marginal bone loss (MBL) and oral mucosal inflammation surrounding dental implants. This retrospective study evaluated the effects of smoking on dental implants in patients with fixed implant-supported prostheses over a period of 36 months following loading. Material/Methods We assessed 120 patients (68 women, 52 men, ages 19–74 years (mean age: 55.10 years) with 315 implants. Implants were classified according to location in the upper and lower jaws and anterior (placed between canines) or posterior (placed between pre-molars and molars) as follows: 1=maxilla anterior, 2=maxilla posterior, 3=mandible anterior, 4=mandible posterior. We also measured MBL, plaque index (PI), sulcus bleeding index (SBI), and probing depth (PD). P-values less than 0.05 were considered statistically significant. Results MBL was statistically greater in smokers (P<0.001) as compared to non-smokers in both jaws. MBL did not vary significantly by location in either group (smokers: p=0.415; non-smokers: p=0.175). Mean PI and PD scores were significantly higher in smokers as compared to non-smokers (P<0.001). A positive correlation was found between PI and PD scores in both groups. No statistically significant difference in SBI was observed between the 2 groups (P>0.05). Conclusions Smoking was associated with increases in marginal bone loss around implants, independent of their location in the jaws. Also, both plaque indices and probing depths were greater in smokers than in non-smokers.
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Affiliation(s)
- Emre Mumcu
- Department of Prosthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
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The Effect of Smoking Behavior on Alveolar Bone Marrow Mesenchymal Stem Cells of Clinical Implant Patient. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7672695. [PMID: 30584539 PMCID: PMC6280244 DOI: 10.1155/2018/7672695] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/05/2018] [Indexed: 12/01/2022]
Abstract
Objective The hazardous effects of smoking on the alveolar bone healing after implant surgery and nicotine on the biofunction of human alveolar bone marrow mesenchymal stem cells (hABMMSCs) were reported. There was little direct evidence regarding the specific detrimental effects of the smoking on hABMMSCs. The aim of this study was to test the influence of smoking behavior on hABMMSCs and the osseointegration situation after implant surgery. Methods hABMMSCs from 6 dental implant patients randomly (3 smokers and 3 nonsmokers) were compared. The cell viability, colony forming unit, and cell cycle were performed to assay proliferation capacity. The Oil Red O staining, Alizarin Red staining, alkaline phosphatase staining and activity, adipogenic and osteogenic gene expressions in vitro, and bone formation ectopically in vivo were performed under proper inductions, respectively, to assay multilineage differentiation. Besides the implant stability quotient and marginal bone loss were checked in both groups. Results Smoking hABMMSCs showed lower proliferation in vitro and poorer bone regeneration capacity in vivo. Moreover, smokers performed worse on bone healing after implant surgery. Conclusions Our results suggested smoking had the detrimental genetic effect on proliferation and osteogenesis of hABMMSCs and the decreased biofunction of hABMMSCs was positively related with bone healing. Clinical Significance The present study provided direct evidence about hazardous effects of smoking behavior on hABMMSCs. Smoking decreased the osteogenesis and proliferation of hABMMSCs in vivo and in vitro, and smoking was positively related with osseointegration reduction. Prevention of smoking behavior may promote biofunction of hABMMSCs and successful rate of dental implant.
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Bahrami G, Vaeth M, Wenzel A, Isidor F. Marginal bone level in two Danish cross-sectional population samples in 1997-1998 and 2007-2008. Acta Odontol Scand 2018; 76:357-363. [PMID: 29648489 DOI: 10.1080/00016357.2018.1460492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this study was to compare the marginal bone level of two randomly selected population samples from 1997/1998 and 2007/2008, with special emphasis on the role of smoking habits and gender. MATERIALS AND METHODS Two cross-sectional randomly selected population samples [1997/1998 (N = 616) and 2007/2008 (N = 396)] were analysed with respect to the marginal bone level. The marginal bone level was measured in full-mouth intraoral radiographs. Information on smoking was gathered using questionnaires. Multiple regression analysis was used in order to adjust for correlating factors (gender, age, smoking habits and number of teeth). RESULTS After adjusting for confounding factors, the population sample from 2007/2008 had on average a slightly, but statistically significantly, more reduced average marginal bone level (0.15 mm) than the population sample from 1997/1998. Men had more reduced marginal bone level than women (0.12 mm). Smokers in both population samples had more reduced marginal bone level than non-smokers (0.39 mm and 0.12 mm for 1997/1998; 0.65 mm and 0.16 mm for 2007/2008). CONCLUSIONS In these populations, sampled 10 years apart, the 2007/2008 population sample had a slightly more reduced marginal bone level than the 1997/1998 population sample. Men had more reduced marginal bone level than women, and smoking is considered a major risk factor for a reduced marginal bone level.
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Affiliation(s)
- Golnosh Bahrami
- Section of Prosthetic Dentistry, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Michael Vaeth
- Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Section of Oral Radiology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Flemming Isidor
- Section of Prosthetic Dentistry, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Roelsgaard IK, Esbensen BA, Østergaard M, Rollefstad S, Semb AG, Christensen R, Thomsen T. Smoking cessation intervention for reducing disease activity in chronic autoimmune inflammatory joint diseases. Hippokratia 2018. [DOI: 10.1002/14651858.cd012958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Ida K Roelsgaard
- Rigshospitalet, Centre of Head and Orthopaedics; Copenhagen Center for Arthritis Research, Department of Rheumatology and Spine Diseases; Glostrup Denmark
| | - Bente A Esbensen
- Rigshospitalet, Centre of Head and Orthopaedics; Copenhagen Center for Arthritis Research, Department of Rheumatology and Spine Diseases; Glostrup Denmark
| | - Mikkel Østergaard
- Rigshospitalet, Centre of Head and Orthopaedics; Copenhagen Center for Arthritis Research, Department of Rheumatology and Spine Diseases; Glostrup Denmark
| | - Silvia Rollefstad
- Diakonhjemmet Hospital; Preventive Cardio-Rheuma Clinic; Oslo Norway
| | - Anne G Semb
- Diakonhjemmet Hospital; Preventive Cardio-Rheuma Clinic; Oslo Norway
| | - Robin Christensen
- Copenhagen University Hospital, Bispebjerg og Frederiksberg; Musculoskeletal Statistics Unit, The Parker Institute; Nordre Fasanvej 57 Copenhagen Denmark DK-2000
| | - Thordis Thomsen
- Rigshospitalet, The Abdominal Centre; Department of Nursing Research; Blegdamsvej 9 Copenhagen Denmark 2200
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Akram Z, Vohra F, Bukhari IA, Sheikh SA, Javed F. Clinical and radiographic peri-implant parameters and proinflammatory cytokine levels among cigarette smokers, smokeless tobacco users, and nontobacco users. Clin Implant Dent Relat Res 2017; 20:76-81. [DOI: 10.1111/cid.12575] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 11/26/2017] [Accepted: 11/29/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Zohaib Akram
- Department of Periodontology, Faculty of Dentistry; Ziauddin University; Karachi Pakistan
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Ishfaq A. Bukhari
- Department of Pharmacology, College of Medicine; King Saud University; Riyadh, Saudi Arabia
| | - Saeed A. Sheikh
- Department of Pharmacology, College of Medicine; King Saud University; Riyadh, Saudi Arabia
| | - Fawad Javed
- Department of General Dentistry; Eastman Institute for Oral Health, University of Rochester; Rochester New York
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Sayardoust S, Omar O, Norderyd O, Thomsen P. Clinical, radiological, and gene expression analyses in smokers and non-smokers, Part 2: RCT on the late healing phase of osseointegration. Clin Implant Dent Relat Res 2017; 19:901-915. [PMID: 28744993 DOI: 10.1111/cid.12514] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND The mechanisms behind the impact of smoking on osseointegration are not fully understood. PURPOSE To investigate the initial clinical and molecular course of osseointegration of different implants in smokers and non-smokers in a randomized controlled trial (RCT). MATERIALS AND METHODS Smoking (n = 16) and non-smoking (n = 16) patients received 3 implant types: machined, oxidized, and laser-modified surfaces. Baseline bone biopsies were retrieved from the implant sites. After 60 and 90 days, the pain score, implant stability quotient (ISQ), and peri-implant crevicular fluid (PICF) gene expression were analyzed. Furthermore, radiological and clinical assessments were made at 90 days. RESULTS At 90 days, no pain was reported, irrespective of smoking habit. A higher ISQ was found in smokers compared with non-smokers. Marginal bone loss (MBL) was greater in smokers than in non-smokers. The comparison of implant surfaces revealed greater MBL exclusively at the machined implants in smokers. At 90 days in smokers, the PICF around machined implants revealed a higher expression of the proinflammatory cytokine, interleukin-6 (IL-6), and a lower expression of the osteogenic gene, osteocalcin (OC), compared with the PICF around modified implants. Furthermore, OC expression was lower at machined implants in smokers compared with machined implants in non-smokers. After adjustment for age and implant location (maxilla/mandible), multivariate regression revealed the following predictors of MBL: smoking, bleeding on probing at 90 days, hypoxia-inducible factor 1 alpha (HIF-1α) expression at baseline and IL-6 expression in PICF at 90 days. CONCLUSIONS During the early phase of osseointegration, non-smokers and smokers present a similar, high implant survival. In contrast, smokers present a greater MBL, particularly at machined implants. HIF-1α baseline expression in the recipient bone and IL-6 expression in PICF cells are important molecular determinants for MBL after 90 days. It is concluded that smoking has an early effect on osseointegration, which is dependent on the implant surface properties and the local host response.
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Affiliation(s)
- Shariel Sayardoust
- 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.,Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Omar Omar
- 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
| | - Ola Norderyd
- 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.,Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Peter Thomsen
- 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
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