Comparison of implant-supported rehabilitation in smokers and non-smokers with conventional and short tuberosity implants: an evaluation of prosthetic, peri-implant, and cytokine profiles.

OBJECTIVE: This study aimed to assess periodontal parameters, radiographic (CBL), and prosthetic parameters along with levels of matrix metalloproteinase-9 (MMP-9) and interleukin-1beta (IL-1beta) in smokers undergoing rehabilitation using conventional implants and short tuberosity implants (STIs). SUBJECTS AND METHODS: The duration of the study was six months. A structured questionnaire was made to be filled out by all participants. The participants were included in the study based on predefined inclusion and exclusion criteria for smokers and non-smokers with STIs. Peri-implant parameters were assessed based on peri-implant plaque index (PIPI), bleeding on probing (BoP), and peri-implant periodontal depth (PIPD) >/=4 mm. Collection of peri-implant crevicular fluid (PICF) and measurement of MMP-9 and IL-1beta was performed using ELISA. Data related to peri-implant clinical and radiographic parameters were reported in mean and percentages. Pearson Chi-square test was employed for categorical data sets, whereas the Kruskal-Wallis test was used for the comparison of means between groups. Bonferroni post hoc adjustment test was applied for multiple comparisons. Differences were found to be significant p<0.01 RESULTS: Among the four groups, one hundred participants were included. The mean age of participants in groups 1 (44+/-4.5 yrs) and 3 (44+/-2.1 yrs) showed no significant difference from participants in groups 2 (42+/-3.8 yrs) and 4 (43+/-3.5 yrs). The duration of the smoking habit in cigarette smokers with STIs was 22.7+/-1.4 yrs, and cigarette smokers with conventional implants were 23.8+/-1.9 yrs with a daily frequency of 11.2+/-2.5 in group 1 and 11.33+/-2.1 in group 3. The means for PIPI and PIPD were found to be significantly worse in cigarette smokers with STIs (PIPI 62.4+/-5.9; PIPD 5.3+/-2.1) and conventional implants (PIPI 63.3+/-6.1; PIPD 5.5+/-1.9) compared to non-smokers with STIs (PIPI 29.2+/-3.6; PIPD 3.1+/-0.1) and conventional implants (PIPI 28.1+/-3.4; PIPD 3.2+/-0.3). BoP was significantly higher in non-smokers compared to smokers with STIs (smokers 24.2+/-8.3; non-smokers 36.5+/-21.2) and conventional implants (smokers 21.6+/-7.4; non-smokers 38.4+/-24.1) (p<0.01). The level of IL-1beta (pg/ml) and the level of MMP-9 (ng/ml) were found to be significantly higher in cigarette smokers with STIs and conventional implants in comparison to non-smokers (p<0.01). CONCLUSIONS: Periodontal (PIPI, PIPD, and BoP) along with radiographic (CBL) and prosthetic parameters were compromised in smokers compared to non-smokers. Patients with conventional implants and STI showed comparable clinical, radiographic, and prosthetic parameters among smokers. Utilization of dental services along with cessation programs should be encouraged for smokers.