Abstract
BACKGROUND: This split-mouth, double-masked, randomized clinical trial aimed at evaluating the impact of different macro geometries and nano topographical modifications on peri-implant bone repair in smokers. METHODS: Thirty-two patients who smoked at least ten cigarettes/day, with the need of a single maxillary or mandibular implant bilaterally, received two implants randomly assigned to DA - Dual Acid-Etched implants (n = 32); HCAN - healing chambers and activated nano surface (n = 32). Implant stability quotient (ISQ) was evaluated 07, 30, 60, 90, and 120 days after implant placement. Levels of bone and angiogenic markers were quantified in the peri-implant fluid after 07, 15, 30, 90, and 120 days of implant insertion. HCAN implants have a higher ISQ than DA implants at 60 days (p < 0.05). RESULTS: PLGF levels were lower for HCAN implants than for DA implants at 07-day period (p < 0.05). Besides, HCAN implants presented higher levels of OPG at 30 days and OPN, BMP-9, FGF-1, PLGF, and VEGF at 90 days, compared to DA implants (p < 0.05). The levels of EGF were higher for HCAN implants at 15, 90, and 120 days compared with DA implants (p < 0.05). HCAN implants also showed lower levels of TNF-α at 07 days in comparison to DA implants (p < 0.05) but had higher levels of DKK1 at 30 days, while DA implants presented higher levels of this marker at 90 days (p < 0.05). CONCLUSION: Macro geometry and nano topographical modifications positively modulated the bone and angiogenic factors, resulting in higher production of these markers during early peri-implant bone healing and having a positive effect on implant stabilization in smokers. TRIAL REGISTRATION: RBR-10gjvcyt; date of registration: 06/12/2023 (Retrospectively registered).