Nicotine effects on the osseointegration of implants with different treatments

doi:10.3969/j.issn.2095-4344.2014.08.001

Abstract

Abstract:

BACKGROUND: Studies have confirmed that nicotine affects the activity of osteoblasts, osteoclasts, fibroblasts and erythrocytes.
OBJECTIVE: To study the nicotine effects on osseointegration and the expression of osteoprotegerin and bone morphogenetic protein 2 after implantation of dental implants with surface treatment by sandblasting or acid etching.
METHODS: Twenty-four Sprague-Dawley rats were randomly assigned to two groups and received daily injections for 2 weeks as follows: Nicotine 2 mg/kg twice for experimental group, saline solution for control group. Then the titanium implants with surface sandblasting or acid etching were implanted into the tibiae followed by continuous nicotine or normal saline injection. At weeks 2 and 4 after implantation, the implants and surrounding bone tissue were prepared for CT, X-ray and hematoxylin-eosin staining examinations to evaluate bone healing and expression levels of bone-related genes were measured by quantitative RT-PCR.
RESULTS AND CONCLUSION: Compared with the control groups, the degree of osseointegration and the expression of osteoprotegerin and bone morphogenetic protein 2 in the experimental groups were decreased significantly (P < 0.05), except that the expression of bone morphogenetic protein 2 in the experimental group with acid etching was not significantly reduced. In addition, the expression of bone morphogenetic protein 2 in the experimental group with acid etching was higher than that in the experimental group with sandblasting at 2 weeks after implantation (P < 0.05). The X-ray and CT show that the quantities of new generation bone and the degree of bone mineralization of the sandblasting group were significant lower than those of the acid etching group under the intervention of nicotine. Hematoxylin-eosin staining showed that the activity and quantity of osteoblasts around the implants down-regulated significantly, but acid etching-treated implants showed better outcomes than sandblasting-treated implants.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: biocompatible materials, dental implants, nicotine, bone morphogenetic proteins, osteoprotegerin

CLC Number:

R318

Sun Xin, Hou Yu-dong, Teng Teng, Xue Peng-fei, Liu Shun-zhen. Nicotine effects on the osseointegration of implants with different treatments[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(8): 1149-1154.

Figures/Tables 4

CT图像：可见种植第2周和第4周时，对照组两种植体周围骨愈合情况均较好，且组间差异不明显；实验组两种种植体在2周时骨组织愈合状况良好，而4周时表面喷砂处理种植体组周围可见明显间隙，间隙范围大于表面酸蚀处理种植体组(图2)。CT骨密度值显示，2周时实验组两种植体周围的骨密度值均低于对照组(P < 0.05)，但实验组和对照组组内表面酸蚀处理种植体与表面喷砂处理种植体骨密度值差异不明显；4周时实验组和对照组组内表面酸蚀处理种植体与表面喷砂处理种植体的骨密度值也无明显差异，但对照组两种植体周围骨密度值随时间变化升高趋势明显 (P < 0.05)，而实验组呈下降趋势，且表面喷砂处理种植体组种植体周围骨密度值的降低趋势更为明显(P < 0.05，表2)。 2.3 荧光定量PCR检测骨保护素与骨形成蛋白2的表达实验组两种植体骨形成蛋白2和骨保护素的表达量随时间变化呈明显下降趋势，而对照组两种植体骨形成蛋白2和骨保护素的表达量随时间变化则呈上升趋势。种植后第2周时可见，实验组组内表面酸蚀处理种植体周围骨形成蛋白2的表达量低于表面喷砂处理种植体(P < 0.05)，而两种植体在骨保护素面的表达量则无明显差异；第4周时，两种植体周围骨形成蛋白2和骨保护素的表达量均出现明显下调，二者差异不明显。实验组两种植体周围骨形成蛋白2和骨保护素的表达量均低于各自的对照组(P < 0.05，图3，表2)。 2.4 组织学观察苏木精-伊红染色显示，植入第2周与第4周时，对照组大鼠种植体周围成骨细胞的活性和数量均明显高于实验组。而尼古丁干预2周时，两种植体周围成骨细胞活跃并整齐排列分布于种植体-骨界面，表面酸蚀处理种植体组成骨细胞的数量和活性高于表面喷砂处理种植体组；在尼古丁干预4周时，表面酸蚀处理种植体周围成骨细胞活性明显降低，数量大幅减少，而表面喷砂处理种植体-骨界面甚至可见活化的破骨细胞分布(图4)。"

References

[1] Wu K,Song W,Zhao L,et al.MicroRNA Functionalized Microporous Titanium Oxide Surface by Lyophilization with Enhanced Osteogenic Activity.ACS Appl Mater Interfaces. 2013;5(7):2733-2744.

[2] Akin H,Guney U.Effect of various surface treatments on the retention properties of titanium to implant restorative cement.Lasers Med Sci.2012;27(6):1183-1187.

[3] Aparicio C,Manero JM,Conde F,et al.Acceleration of apatite nucleation on microrough bioactive titanium for bone-replacing implants.J Biomed Mater Res. 2007;82: 521-529.

[4] Prodanov L,Lamers E,Domanski M,et al.The effect of nanometric surface texture on bone contact to titanium implants in rabbit tibia. Biomaterials. 2013;34(12):2920- 2927.

[5] Zhang F,Zhang CF,Yin MN,et al.Effect of heat treatment on H2O2/HCl etched pure titanium dental implant:an in vitro study.Med Sci Monit.2012;18(7):265-272.

[6] Yamada M,Ueno T,Minamikawa H,et al.Early-stage osseointegration capability of a submicrofeatured titanium surface created by microroughening and anodic oxidation. Clin Oral Implants Res.2013;24(9):991-1001.

[7] Akhter MP,Lund AD,Gairola CG.Bone biomechanical property deterioration due to tobacco smoke exposure.J Bone Miner Res.2005;77(5):319-326.

[8] Korpelainen R,Korpelainen J,Heikkinen J,et al.Lifelong risk factors for osteoporosis and fractures in elderly women with low body mass index-A population-based study.Bone.2006; 39(2): 385-391.

[9] Silcox D, Daftari KT,Bodden MK,et al.The effect of nicotine on spine fusion.Spine (Phila Pa 1976).1995;20:1594-1553.

[10] Sherwin M,Gastwirth C.Detrimental effects of cigarette smoking on lower extremity wound healing.J Foot Surg.1990;29:84-87.

[11] Raikin SM,Landsman JC,Alexander VA,et al.Effect of nicotine on the rate and strength of long bone fracture healing. Clin Orthop Relat Res.1998;353:231-237.

[12] Alzoubi KH,Srivareerat M,Tran TT,et al.Role of α7- and α4β2-nAChRs in the neuroprotective effect of nicotine in stress-induced impairment of hippocampus-dependent memory.Int J Neuropsychopharmacol.2013;16(5):1105-1113.

[13] Berley J,Yamano S,Sukotjo C.The effect of systemic nicotine on osseointegration of titanium implants in the rat femur.J Oral Implantol. 2010;36(3):185-193.

[14] 刘献文,逯素芬,于爱兰,等.改良尼古丁依赖_戒断大鼠模型的建立与疼痛敏感性观察[J].国际麻醉学与复苏学杂志,2013,34(7):591-640.

[15] Malin DH,Lake JR,Newlin-Maultsby P,et al.Rodent model of nicotine abstinence syndrome.Pharmacol Biochem Behav. 1992;43(3):779-784.

[16] Duarte PM,de Mendonga AC,Maximo MB,et al.Differential cytokine expressions affect the severity of peri-implant disease. J Clin Oral Implants Res.2009;20(5):514-520.

[17] Hofbauer LC,Khosla S,Dunstan CR,et al.The roles of osteoprotegerin and osteoprotegerin ligand in the paracrine regulation of bone resorption.J Bone Miner Res.2000;15(1): 2-12.

[18] Derynck R,Zhang Y.Smad-dependent and Smad-independent pathways in TGF-beta family signaling.Nature. 2003;425(6958):577-584.

[19] Schmierer B,Hill CS.TGF beta-SMAD signal transduction: molecular specificity and functional flexibility. Nat Rev Mol Cell Biol.2007;8(12):970-982.

[20] Akin H,Guney U.Effect of various surface treatments on the retention properties of titanium to implant restorative cement.Lasers Med Sci.2012;27(6):1183-1187.

[21] 孙轲,侯玉东.烟草浸提液对牙龈成纤维细胞在钛板上粘附增殖的影响[J].实用口腔医学杂志,2009,25(1):80-83.

[22] 侯玉东,沈建英,王桂龙,等.烟草浸提液对大鼠成骨细胞在钛板上附着和增殖的影响[J].实用口腔医学杂志, 2011,27(1):17-20.

[23] Egger P,Duggleby S,Hobbs R,et al.Cigarette smoking and bone mineral density in the elderly.J Epidemiol Community Health.1996;50:47-50.

[24] Lemons JE,Laskin DM,Roberts WE,et al.Changes in patient screening for a clinical study of dental implants after increased awareness of tobacco use as a risk factor.J Oral Maxillofac Surg.1997;55:72-75.

[25] Yamano S,Berley JA,Kuo WP,et al.Effects of nicotine on gene expression and osseointegration in rats.Clin Oral Implants Res. 2010;21(12):1353-1359.

[26] Pereira ML,Carvalho JC,Peres F,et al.Simultaneous effects of nicotine, acrolein, and acetaldehyde on osteogenic-induced bone marrow cells cultured on plasma-sprayed titanium implants.Int J Oral Maxillofac Implants.2010;25(1):112-122.

[27] Hoffmann D,Hoffmann I.The musculoskeletal effects of smoking.J Am Acad Orthop Surg.2001;9:9-17.