Implant-associated gene expression in the jaw bone of smokers and nonsmokers: A human study using quantitative qPCR

Abstract

Objectives: This study aimed to compare the molecular events in implant-adherent cells and in peri-implant bone during the osseointegration of machined and oxidized titanium implants in smokers and nonsmokers.

Materials and methods: Twenty-four smokers and 24 nonsmokers each received machined and anodically oxidized mini-implants. The mini-implants and the surrounding bone were retrieved after 1, 7, and 28 days, for gene expression analysis of selected factors using quantitative polymerase chain reaction (qPCR).

Results: Differences between machined and oxidized implants were more evident in the implant-adherent cells than the peri-implant bone. The machined implants revealed higher expression of proinflammatory cytokines, interleukin-8 (IL-8) (in nonsmokers), and tumor necrosis factor-alpha (in nonsmokers and smokers), compared with the oxidized implants. Conversely, the expression of bone formation genes, alkaline phosphatase and osteocalcin, was generally higher at the oxidized implants. In smokers, the temporal pattern revealed the delayed and initial inhibition of osteoblastic and osteoclastic gene expression, respectively, mainly at the machined implants. In contrast, oxidized implants revealed higher expression of bone remodeling, cathepsin K (CatK) and calcitonin receptor, and coupling, receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin, genes after 7 day in smokers.

Conclusions: The implant-adherent cells are more sensitive to surface properties and smoking conditions than the cells in the peri-implant bone. Smoking imposes inhibitory effects on the initial molecular events of osseointegration in the human bone-implant interface. The surface properties of oxidized implants appear to have a beneficial effect on osseointegration by mitigating the smoking-induced negative effects.

Keywords: bone-implant interactions; clinical research, clinical trials; genetics; host mechanisms; material sciences; smoking.