May dental implant macro and microgeometry modifications influence peri-implant bone repair in smokers? A randomized clinical trial.

Resumo (EN)

Background This split-mouth, double-masked, randomized clinical trial aimed at evaluating the impact of different
macro geometries and nano topographical modifications on peri-implant bone repair in smokers.
Methods Thirty-two patients who smoked at least ten cigarettes/day, with the need of a single maxillary or
mandibular implant bilaterally, received two implants randomly assigned to DA - Dual Acid-Etched implants (n=32);
HCAN – healing chambers and activated nano surface (n=32). Implant stability quotient (ISQ) was evaluated 07,
30, 60, 90, and 120 days after implant placement. Levels of bone and angiogenic markers were quantified in the
peri-implant fluid after 07, 15, 30, 90, and 120 days of implant insertion. HCAN implants have a higher ISQ than DA
implants at 60 days (p<0.05).
Results PLGF levels were lower for HCAN implants than for DA implants at 07-day period (p<0.05). Besides, HCAN
implants presented higher levels of OPG at 30 days and OPN, BMP-9, FGF-1, PLGF, and VEGF at 90 days, compared
to DA implants (p<0.05). The levels of EGF were higher for HCAN implants at 15, 90, and 120 days compared with
DA implants (p<0.05). HCAN implants also showed lower levels of TNF-α at 07 days in comparison to DA implants
(p<0.05) but had higher levels of DKK1 at 30 days, while DA implants presented higher levels of this marker at 90 days
(p<0.05).
Conclusion Macro geometry and nano topographical modifications positively modulated the bone and angiogenic
factors, resulting in higher production of these markers during early peri-implant bone healing and having a positive
effect on implant stabilization in smokers.
Trial Registration RBR-10gjvcyt; date of registration: 06/12/2023 (Retrospectively registered).