Hamid Dania, Ahmed Shaheen, Shaikh Abdul Hafeez, Nisar Sadaf, Memon Raheel, Malik Samreen
Department of Oral and Maxillofacial Surgery, Dow International Dental College, Dow University of Health Sciences, Karachi, Pakistan.
Department of Oral Medicine, Liaquat College of Medicine and Dentistry, Karachi, Pakistan.
BMC Oral Health. 2025 Jul 2;25(1):1013. doi: 10.1186/s12903-025-05529-x.
Implants are commonly used as a treatment choice for partially dentate or edentulous patients. Currently, no specific biomarker for assessing the bone status around dental implants of healthy patients has been reported for evaluating bone deposition, resorption, or stability. CTXI (C-terminal telopeptide of type I collagen) is a known specific biomarker for bone resorption. However, CTXI levels in the saliva of healthy patients with dental implants have not been investigated.
This randomized controlled trial aimed to evaluate salivary CTXI levels in dental implant patients with early and delayed loading and to compare them with the values of the periotest to determine implant stability and loading time.
This study was conducted in Karachi, Pakistan, and included 40 patients with dental implants placed in the posterior mandible. Patients were randomly divided into two groups based on the timing of implant loading: an early loading group, where implants were functionally loaded within 1 month of placement, and a delayed loading group, where implants were loaded after 3 months. The intervention involved functional loading of the implants according to the assigned group. Implant stability was assessed using a periotest on the day of surgery and at 1 month or 3 months, depending on the group. Additionally, saliva samples were collected from all patients at 1 month and 3 months to evaluate CTXI expression levels using sandwich ELISA.
A comparison by periotest showed that dental implants were stable in the early loading group and that osseointegration was good; thus, loading could be applied within one month of dental implant placement. However, in our study, the CTXI bone turnover marker was not detected in any group and thus cannot be used to indicate bone implant stability or loading time.
This study demonstrates that early loading of dental implants can achieve stability and osseointegration within one month, as confirmed by Periotest measurements. However, salivary CTXI levels were undetectable in both early and delayed loading groups, indicating that this biomarker is unsuitable for assessing bone-implant stability or determining the optimal timing for implant loading in healthy patients. These findings suggest further research to explore alternative biomarkers for non-invasive osseointegration and implant stability monitoring.
Retrospectively registered, ID: NCT06246097, Date of registration: 07/02/2024, ( https://clinicaltrials.gov/ct2/show/NCT06246097 ).
种植体常用于部分牙列缺损或无牙患者的治疗。目前，尚未有用于评估健康患者牙种植体周围骨状态以评价骨沉积、吸收或稳定性的特异性生物标志物的报道。I型胶原C末端肽（CTXI）是一种已知的骨吸收特异性生物标志物。然而，健康牙种植体患者唾液中的CTXI水平尚未得到研究。
本随机对照试验旨在评估早期和延期负重的牙种植体患者的唾液CTXI水平，并将其与牙周测试值进行比较，以确定种植体稳定性和负重时间。
本研究在巴基斯坦卡拉奇进行，纳入40例在下颌后部植入牙种植体的患者。根据种植体负重时间，患者被随机分为两组：早期负重组，种植体在植入后1个月内进行功能负重；延期负重组，种植体在3个月后进行负重。干预措施为根据分组对种植体进行功能负重。在手术当天以及术后1个月或3个月（取决于分组）使用牙周测试仪评估种植体稳定性。此外，在术后1个月和3个月从所有患者收集唾液样本，采用夹心ELISA法评估CTXI表达水平。
牙周测试比较显示，早期负重组的牙种植体稳定，骨结合良好，因此可在牙种植体植入后1个月内进行负重。然而，在我们的研究中，任何一组均未检测到CTXI骨转换标志物，因此其不能用于指示种植体骨稳定性或负重时间。
本研究表明，经牙周测试仪测量证实，牙种植体早期负重可在1个月内实现稳定性和骨结合。然而，早期和延期负重组的唾液CTXI水平均未检测到，表明该生物标志物不适用于评估健康患者的种植体骨稳定性或确定种植体负重的最佳时机。这些发现提示需进一步研究以探索用于无创性骨结合和种植体稳定性监测的替代生物标志物。
回顾性注册，标识符：NCT06246097，注册日期：2024年2月7日，（https://clinicaltrials.gov/ct2/show/NCT06246097）
