Abstract
Smoking is considered a key risk factor for implant survival; however, how it interacts with the pathogens in peri-implant infections is not clear. Here, we identified that nicotine, the key component of cigarette smoking, can interact with Staphylococcus aureus and synergistically induce peri-implant infections in a rat osteolysis model. The nicotine–S. aureus combination group increased the gross bone pathology, osteolysis, periosteal reactions, and bone resorption compared to the nicotine or S. aureus single treated group (p < 0.05). Nicotine did not promote the proliferation of S. aureus both in vitro and in vivo, but it can significantly upregulate the expression of staphylococcal protein A (SpA), a key virulence factor of S. aureus. The nicotine–S. aureus combination also synergistically activated the expression of RANKL (receptor activator of nuclear factor-kappa B ligand, p < 0.05) to promote the development of peri-implant infections. The synergistic effects between nicotine and S. aureus infection can be a new target to reduce the peri-implant infections.
Highlights
The dental implant, as an osseointegration technique, has become one of the most common strategies for prosthetic rehabilitation (Amornvit P, 2014)
There was a large scale of bone resorption and sequestrum formation in the nicotine–S. aureus combination group, while little bone infection was observed in the nicotine group (Figure 2A) indicating the synergism between nicotine and S. aureus
There was no significant difference in the radiographical scores among the groups at one day after surgery, but the radiographical scores of the S. aureus and the nicotine–S. aureus combination groups were significantly higher after three weeks (Figure 2B)
Summary
The dental implant, as an osseointegration technique, has become one of the most common strategies for prosthetic rehabilitation (Amornvit P, 2014). The osseointegration technique has been extended to orthopedics, limb amputees, total joint replacements, maxillofacial reconstruction, and orbital prostheses due to its superiority in mobility and biocompatibility (Hebert et al, 2017; Depypere et al, 2020; Lu et al, 2020). Peri-implant infections, as one of the major inflammatory complications, can cause suppuration, revision surgery, and even removal of the prostheses (Albrektsson T, 1994; Annibali S, 2008; Lindhe et al, 2008; Lang et al, 2011; Romano et al, 2013; Zimmerli and Sendi, 2017; Schwarz et al, 2018; Carrasco-Garcia et al, 2019; Kordbacheh Changi et al, 2019; Rokaya et al, 2020). Peri-implant infections dramatically increased the medical costs and human sufferings (Seebach and Kubatzky, 2019; Depypere et al, 2020; Zhou et al, 2020)
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