Abstract
Smoking is a major risk factor for dental implant failure. In addition to higher marginal bone loss around implants, the cellular and molecular responses to injury and implant physicochemical properties are also differentially affected in smokers. The purpose of this work is to determine if smoking impairs bone microstructure and extracellular matrix composition within the dental alveolar socket after tooth extraction. Alveolar bone biopsies obtained from Smokers (> 10 cigarettes per day for at least 10 years) and Ctrl (never-smokers), 7–146 months after tooth extraction, were investigated using X-ray micro-computed tomography, backscattered electron scanning electron microscopy, and Raman spectroscopy. Both Smokers and Ctrl exhibited high inter- and intra-individual heterogeneity in bone microstructure, which varied between dense cortical and porous trabecular architecture. Regions of disorganised/woven bone were more prevalent during early healing. Remodelled lamellar bone was predominant at longer healing periods. Bone mineral density, bone surface-to-volume ratio, mineral crystallinity, the carbonate-to-phosphate ratio, the mineral-to-matrix ratio, the collagen crosslink ratio, and the amounts of amino acids phenylalanine and proline/hydroxyproline were also comparable between Smokers and Ctrl. Bone microstructure and composition within the healing dental alveolar socket are not significantly affected by moderate-to-heavy smoking.
Highlights
Smoking is a global health problem, with increased healthcare and societal costs owing to diminished healing capacities and risk of with premature mortality [1, 2]
For the first time, that the extracellular matrix composition of the healed site is not affected significantly by smoking, and poor bone quality at the implant recipient site may be disregarded as a potential explanation for implant failures in moderate-to-heavy smokers
Regions of woven bone characterised by the presence of disorganised clusters of osteocytes were, typically, more prevalent during early healing, while remodelled lamellar bone was predominant at longer healing periods (Fig. 2)
Summary
Smoking is a global health problem, with increased healthcare and societal costs owing to diminished healing capacities and risk of with premature mortality [1, 2]. Structure of collagen, and atypical variations in mineral content For this purpose, bone biopsies obtained between 7 and 146 months after tooth extraction were investigated using Raman spectroscopy in addition to X-ray micro-computed tomography (micro-CT) and backscattered electron scanning electron microscopy (BSE-SEM). Bone biopsies obtained between 7 and 146 months after tooth extraction were investigated using Raman spectroscopy in addition to X-ray micro-computed tomography (micro-CT) and backscattered electron scanning electron microscopy (BSE-SEM) It is demonstrated, for the first time, that the extracellular matrix composition of the healed site is not affected significantly by smoking, and poor bone quality at the implant recipient site may be disregarded as a potential explanation for implant failures in moderate-to-heavy smokers
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