Clinical study of the influence of different macrogeometries and surface treatments of dental implants inserted in smoking patients. Clinical aspects and immunological

This split-mouth, doble-blind, randomized clinical trial aimed at evaluating the impact of different macrogeometries and nanotopographical modifications on peri-implant bone repair in smokers. Thirty-two patients who smoked at least 10 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 nanosurface (n=32). Implant stability quotient (ISQ) was evaluated at 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 higher ISQ than DA implants at 60 days (p<0.05). PLGF levels were lower for HCAN implants than to DA implants at 07 days period (p<0.05). Besides, HCAN implants presented higher levels of OPG at 30 days period and OPN, BMP-9, FGF-1, PLGF and VEGF at 90 days period, when compared to DA implants (p<0.04). The levels of EGF were higher for HCAN implants at 15, 90 and 120 days comparing with DA implants (p<0.05). HCAN implants also showed lower levels of TNF-a at 07 days (p<0.05) in comparison to DA implants (p<0.05) but had higher levels of DKK1 at 30 days in while DA implants presented higher level of this marker at 90 days (p<0.05). Macrogeometry and nanotopographical modifications positively modulated the bone and angiogenic factors resulting in higher production of these markers during early peri-implant bone healing and had positive effect on implant stabilization in smokers.