Relation Between Smoking and Biomarkers of Bone Resorption Associated With Dental Endosseous Implants

Relation Between Smoking and Biomarkers of Bone Resorption Associated With Dental Endosseous Implants
2004
Oates, Thomas W. DMD, PhD*; Caraway, Damen DDSÇƒÜ; Jones, John DDSÇƒ?
Implant Dentistry: Volume 13(4) 2004 pp 352-357
Lippincott Williams & Wilkins
*Associate Professor, Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio Texas.
ÇƒÜResident, Department of Orthodontics, St. Louis University, St. Louis, MO.
Çƒ?Resident, Department of Orthodontics, University of Texas Health ScienceCenter at San Antonio, San Antonio TX.
Reprint requests and correspondence to:
Thomas Oates, DMD, PhD; Department of Periodontics; University of Texas Health Science Center at San Antonio; 7703 Floyd Curl Drive; San Antonio TX 78229; Phone: (210) 567-3590; Fax: (210) 567-6858; E-mail: oates@uthscsa.edu
Abstract
The aim of this study was to determine the effects of smoking on pyridinoline concentrations in crevicular fluid collected from around dental implants. Samples of crevicular fluid were collected from 4 sites around each implant and tooth, if present, for a group of 16 patients using methylcellulose strips. Samples were collected from 104 implants and 49 teeth. Eight of the 16 patients were current smokers. Crevicular fluid samples were eluted from methylcellulose strips using phosphate-buffered saline containing 0.1% bovine serum albumin and centrifugation. Pyridinoline was quantified using a competitive enzyme immunoassay. Results showed that there were statistically insignificant differences between the amounts of pyridinoline (mean ¨± standard deviation [SD]) around teeth of nonsmokers versus smokers (0.011 ¨± 0.003 and 0.014 ¨± 0.006 nmol/L, respectively). However, the mean (¨± SD) pyridinoline levels around the implants of nonsmokers (0.012 ¨± 0.018 nmol/L) were significantly (P <0.01) less than that of smokers (0.030 ¨± 0.006 nmol/L). These results demonstrate that pyridinoline levels are specifically elevated in the crevicular fluid associated with endosseous dental implants of smokers and suggest that smoking may affect implant success in part through alterations in the levels of bone resorption.
Endosseous dental implants represent a viable alternative for many patients in need of a dental prosthesis. Although high levels of success have been achieved for implant therapy, there are those unfortunate few patients who lose implants. Given the infrequency of implant-related complications, and the number of factors that can have a significant impact on the prognosis of implants, it is difficult to attribute failure to one particular origin. However, the literature has suggested that smoking, even light smoking, may play the most significant role in implant failure.1-3
Peri-implantitis is an inflammatory process affecting the tissues surrounding an osseointegrated implant in function resulting in loss of supporting bone.4 The progression of this particular process may ultimately lead to the loss of the implant and associated prosthesis. Regular maintenance of implants is critical to monitor the peri-implant situation for early detection of signs of implant failure.5 At present, diagnostic markers for the early recognition of peri-implantitis and possible implant failure are needed.
Recent diagnostic approaches targeting gingival crevicular fluid (GCF), which is a transudate that can be obtained from the gingival sulcus or periodontal pocket, have shown promise in identifying disease activity.6 As GCF is released from the inflamed tissue, it appears to carry biochemical markers associated with tissue breakdown.7 Samples of GCF, therefore, offer great potential to assess molecules associated with active tissue destruction.6 Pyridinoline (PYD) and pyridinoline crosslinked carboxyterminal telopeptide of type I collagen (ICTP), molecules specific to the collagen matrix of bone and cartilage, have surfaced as a promising diagnostic tool.8,9 These molecules have demonstrated strong correlations between pyridinoline levels and radiographic and histologic signs of tissue destruction.10-12 As such, these molecules may be useful in assessing metabolic alterations in the osseous tissue associated with the implant and have the potential to provide a more sensitive view of the effects of systemic factors such as smoking on bone metabolism. Therefore, the purpose of this study was to examine the association between PYD levels in peri-implant crevicular fluid (PICF) and smoking in patients with restored implants.
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