Effect of choline-stabilized orthosilicic acid versus vitamins C and E on peri-implant procollagen type I N-terminal propeptide levels in smokers receiving dental implants: a randomized clinical study

Divya Gupta; Sumit Malhotra; Aruna Nautiyal; Tanya Attre; Anoushka Pandey; Rahul Chopra

doi:10.18203/2349-3259.ijct20262799

Authors

Divya Gupta Department of Periodontology and Oral Implantology, ITS Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
Sumit Malhotra Department of Periodontology and Oral Implantology, ITS Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
Aruna Nautiyal Department of Periodontology and Oral Implantology, ITS Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
Tanya Attre Department of Periodontology and Oral Implantology, ITS Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
Anoushka Pandey Department of Periodontology and Oral Implantology, ITS Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
Rahul Chopra Department of Periodontology and Oral Implantology, ITS Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3259.ijct20262799

Keywords:

Dental implants, Smoking, Choline-stabilized orthosilicic acid, Vitamin C and E, Peri-implant bone loss

Abstract

Background: Smoking adversely affects peri-implant wound healing, osseointegration, and crestal bone stability through increased oxidative stress and impaired bone metabolism. Nutritional supplementation with bone-forming and antioxidant agents, such as choline-stabilized orthosilicic acid (ch-OSA) and vitamins C and E, may improve implant outcomes in smokers; however, comparative evidence remains limited.

Methods: Twenty-eight smokers undergoing dental implant placement were randomly allocated into two groups. Group A received ch-OSA, while group B received combined vitamin C and vitamin E supplementation for one month postoperatively. Clinical parameters, including plaque index (PI), gingival index (GI), wound healing index (WHI), and implant stability quotient (ISQ), were recorded at baseline and 3 months. Crestal bone levels were assessed using standardized intraoral periapical radiographs at baseline, 1 month, and 3 months. Peri-implant crevicular fluid samples were collected on days 7, 15, and 30 to measure procollagen type I N-terminal propeptide (PINP) levels using ELISA.

Results: Both groups showed significant improvements in clinical parameters and implant stability over time (p<0.05), with no significant intergroup differences. Although crestal bone loss occurred in both groups, significantly greater bone loss was observed in the vitamin C and E group at 1 and 3 months (p<0.05). PINP levels increased significantly in both groups, with consistently higher values in the ch-OSA group (p<0.05).

Conclusions: Ch-OSA supplementation promoted greater bone formation activity and reduced crestal bone loss compared with vit C and E supplementation, suggesting superior support for early peri-implant healing in smokers.

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