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.

Metrics

Metrics Loading ...

References

Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg. 1977;16:1-132.

Heitz-Mayfield LJA, Salvi GE. Peri-implant mucositis and peri-implantitis. J Clin Periodontol. 2018;45(20):S246-63. DOI: https://doi.org/10.1111/jcpe.12953

Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, De Bruyn H, Figuero E, et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop. J Clin Periodontol. 2018;45(20):S286-91. DOI: https://doi.org/10.1111/jcpe.12957

Strietzel FP, Reichart PA, Kale A, Kulkarni M, Wegner B, Küchler I. Smoking interferes with the prognosis of dental implant treatment: a systematic review and meta-analysis. J Clin Periodontol. 2007;34(6):523-44. DOI: https://doi.org/10.1111/j.1600-051X.2007.01083.x

Baig MR, Rajan M. Effects of smoking on the outcome of implant treatment: a literature review. Indian J Dent Res. 2007;18(4):190-5. DOI: https://doi.org/10.4103/0970-9290.35831

Bain CA, Moy PK. The association between failure of dental implants and cigarette smoking. Int J Oral Maxillofac Implants. 1993;8:609-15.

Ward KD, Klesges RC. A meta-analysis of the effects of cigarette smoking on bone mineral density. Osteoporos Int. 2001;12(12):1050-7.

Liang D, Wang KJ, Tang ZQ, Liu RH, Zeng F, Cheng MY, et al. Effects of nicotine on metabolism and gene expression of rat osteoblasts. Mol Med Rep. 2018;17(6):8269-81.

Ram VS, Parthiban S, Sudhakar U, Mithradas N, Prabhakar R. Bone biomarkers in periodontal disease: a review. J Clin Diagn Res. 2015;9(1):ZE07-10.

Hale LV, Sells Galvin RJ, Risteli J, et al. PINP: a serum biomarker of bone formation in the rat. Bone. 2007;40(4):1103-9. DOI: https://doi.org/10.1016/j.bone.2006.11.027

Schwarz F, Derks J, Monje A, Wang HL. Biomarkers from peri-implant crevicular fluid as predictors of peri-implant bone loss: a systematic review. Int J Mol Sci. 2023;24(4):3202. DOI: https://doi.org/10.3390/ijms24043202

Qi F, Huang H, Wang M, Rong W, Wang J. Applications of antioxidants in dental procedures. Antioxidants. 2022;11(12):2492. DOI: https://doi.org/10.3390/antiox11122492

Traber MG, Stevens JF. Vitamins C and E: beneficial effects from a mechanistic perspective. Free Radic Biol Med. 2011;51(5):1000-13. DOI: https://doi.org/10.1016/j.freeradbiomed.2011.05.017

Prabhoo R. Choline-stabilized orthosilicic acid and bone health. Curr Med Issues. 2020;18(4):312-6. DOI: https://doi.org/10.4103/cmi.cmi_78_20

Spector TD, Calomme MR, Anderson SHC, Clement G, Bevan L, Demeester N, et al. Choline-stabilized orthosilicic acid supplementation stimulates markers of bone formation in osteopenic females. BMC Musculoskelet Disord. 2008;9:85. DOI: https://doi.org/10.1186/1471-2474-9-85

Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand. 1963;21:533-51. DOI: https://doi.org/10.3109/00016356309011240

Vandana S, Goyal P, Singh ST, Kaur S, Suchdev V. Vitamin C supplementation in wound healing post dental implant surgery. J Pharm Res Int. 2023;35(33):1-7. DOI: https://doi.org/10.9734/jpri/2023/v35i337472

Li X, Tang L, Lin YF, Xie GF. Role of vitamin C in wound healing after implant surgery. Clin Implant Dent Relat Res. 2018;20(5):793-8. DOI: https://doi.org/10.1111/cid.12647

Tüter G, Yildirim AZ, Duman AN, Behruz A, Atak-Yucel A, Oruklu N, et al. Smoking effect on bone ALP and implant stability. Odontology. 2022;110(3):596-604. DOI: https://doi.org/10.1007/s10266-021-00685-2

Jugdaohsingh R, Reffitt DM, Oldham C, Cheung HFJ, Evans BAJ, Thompson RPH, et al. Orthosilicic acid stimulates collagen type I synthesis. Bone. 2003;32(2):127-35.

Javed F, Romanos GE. Role of primary stability for implant success. J Dent. 2010;38(8):612-20. DOI: https://doi.org/10.1016/j.jdent.2010.05.013

Mumcu E, Beklen A. Smoking and marginal bone loss around implants. Tob Induc Dis. 2019;17:43. DOI: https://doi.org/10.18332/tid/109279

Reffitt DM, Ogston N, Jugdaohsingh R, Cheung HFJ, Evans BAJ, Thompson RPH, et al. Orthosilicic acid and osteoblast differentiation. Bone. 2003;32(2):127-35. DOI: https://doi.org/10.1016/S8756-3282(02)00950-X

Singh S, Bhoi S, Parmar H. Marginal bone loss in smokers vs non-smokers. J Oral Biol Craniofac Res. 2023;13(2):145-50.

Nazeer J, Singh R, Suri P, Mouneshkumar CD, Bhardwaj S, Iqubal MA, et al. Evaluation of marginal bone loss around dental implants in cigarette smokers and nonsmokers. A comparative study. J Family Med Prim Care. 2020;9(2):729-34. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1023_19

Teughels W, Celik E, Tarce M, Cock ID, Persyn SM, Haytac MC. The effect of choline-stabilized orthosilicic acid in patients with peri-implantitis: an exploratory randomized, double-blind, placebo controlled study. Clin Oral Investig. 2021;25(2):673-83. DOI: https://doi.org/10.1186/s12903-021-01817-4

Vallibhakara O, Nakpalat K, Sophonsritsuk A. Tocopherols and bone turnover markers. J Obstet Gynaecol Res. 2021;47(7):2343-50.

Gillett MJ, Vasikaran SD, Inderjeeth CA. PINP in metabolic bone disease. Clin Biochem Rev. 2021;42(1):3-10. DOI: https://doi.org/10.33176/AACB-20-0001