Publication:

Effect of choline-stabilized orthosilicic acid versus vitamins C and E on peri-implant procollagen type I N-terminal propeptide levels in smokers receiving dental implants: a randomized clinical study

Background Smoking adversely affects peri-implant wound healing, osseointegration, and crestal bone stability through increased oxidative stress and impaired bone metabolism. Nutritional supplementation with bone-forming and antioxidant agents, such as choline-stabilized orthosilicic acid (ch-OSA) and vitamins C and E, may improve implant outcomes in smokers; however, comparative evidence remains limited.

Methods Twenty-eight smokers undergoing dental implant placement were randomly allocated into two groups. Group A received ch-OSA, while group B received combined vitamin C and vitamin E supplementation for one month postoperatively. Clinical parameters, including plaque index (PI), gingival index (GI), wound healing index (WHI), and implant stability quotient (ISQ), were recorded at baseline and 3 months. Crestal bone levels were assessed using standardized intraoral periapical radiographs at baseline, 1 month, and 3 months. Peri-implant crevicular fluid samples were collected on days 7, 15, and 30 to measure procollagen type I N-terminal propeptide (PINP) levels using ELISA.

Results Both groups showed significant improvements in clinical parameters and implant stability over time (p<0.05), with no significant intergroup differences. Although crestal bone loss occurred in both groups, significantly greater bone loss was observed in the vitamin C and E group at 1 and 3 months (p<0.05). PINP levels increased significantly in both groups, with consistently higher values in the ch-OSA group (p<0.05).

Conclusions Ch-OSA supplementation promoted greater bone formation activity and reduced crestal bone loss compared with vit C and E supplementation, suggesting superior support for early peri-implant healing in smokers.