Effects of alcohol and nicotine on the mechanical resistance of bone and bone neoformation around hydroxyapatite implants

  • Evelise V. Soares
  • Wagner J. Fávaro
  • Valéria H. A. Cagnon
  • Celso A. Bertran
  • José A. Camilli
Original Article


The consumption of alcohol or nicotine is harmful to the integrity of bone tissue, hindering or even impeding the fixation and maintenance of bone implants. The aim of the present work was to evaluate the effects of ethanol and nicotine, when consumed alone and simultaneously, on both bone mechanical resistance and bone neoformation around hydroxyapatite implants. Twenty rats were divided into four groups: control (CT), alcohol (A), nicotine (N) and nicotine + alcohol (N + A). After 4 weeks of alcohol and/or nicotine consumption, dense (HAD) and porous (HAP) bodies were respectively implanted in a surgically produced bone defect in the right and left tibiae. After the surgeries, the animals continued to consume alcohol and/or nicotine. After ninety days, the animals were sacrificed and the tibiae and femurs were isolated for histological processing and mechanical assays. All the animals presented newly formed bone tissue close to the HAD and HAP ceramic bodies. The animals of the N + A group presented a smaller volume of neoformed bone. Group A animals presented smaller bone volume around the implants in relation to the animals from group N. Bone resistance to mechanical loads was smallest in animals from the N + A group, followed (in order) by the A and N groups. Thus, it can be concluded that nicotine or alcohol consumption produced negative effects on bone mechanical resistance and on the osteogenesis around the HAD and HAP implants. In addition, the simultaneous consumption of the two substances intensified their harmful effects.


Bone Alcohol Nicotine Hydroxyapatite Implants 


  1. 1.
    Bertran CA, Kawachi EY, Reis RR, Alves O (2000) Biocerâmicas: tendências e perspectivas de uma área interdisciplinar. Quim Nova 23:123–129Google Scholar
  2. 2.
    Sakamura CE, Marcantonio JE, Rezende MLR (2001) O efeito do tabagismo na implantodontia. BCI Curitiba 8:276–280Google Scholar
  3. 3.
    Canter HI, Vargel I, Mavili ME (2007) Reconstruction of mandibular defects using autografts combined with demineralized bone matrix and cancellous allograft. J Craniofac Surg 18:95–100CrossRefPubMedGoogle Scholar
  4. 4.
    Marcacci M, Kon E, Moukhachev V, Lavroukov A, Kutepov S, Quarto R, Mastrogiacomo M, Cancedda R (2007) Stem cells associated with macroporous bioceramics for long bone repair: 6- to 7-year outcome of a pilot clinical study. Tissue Eng 13:947–955CrossRefPubMedGoogle Scholar
  5. 5.
    Tadros M, Costantino PD (2008) Advances in cranioplasty: a simplified algorithm to guide cranial reconstruction of acquired defects. Facial Plast Surg 24:135–145CrossRefPubMedGoogle Scholar
  6. 6.
    Legeros RZ (2002) Properties of osteoconductive biomaterials: calcium phosphates. Clin Orthop Rel Res 395:81–98CrossRefGoogle Scholar
  7. 7.
    Gorna K, Gogolewski S (2006) Biodegradable porous polyurethane scaffolds for tissue repair and regeneration. J Biomed Mater Res A 79:128–138PubMedGoogle Scholar
  8. 8.
    Ono I, Tateshita T, Nakajima T (2000) Evaluation of a high density polyethylene fixing system for hydroxyapatite ceramic implants. Biomaterial 21:143–146CrossRefGoogle Scholar
  9. 9.
    Bobyn JD, Pilliar RM, Cameron HU, Weatherly GC (1980) The optimum pore size for the fixation of porous-surfaced metal implants by the ingrowth of bone. Clin Orthop Related Res 150:263–270Google Scholar
  10. 10.
    Levin L, Schwartz-Arad D (2005) The effect of cigarette smoking on dental implants and related surgery. Implant Dent 14:357–361PubMedGoogle Scholar
  11. 11.
    Trevisiol CH, Turner RT, Pfaff JE, Hunter JC, Menagh PJ, Hardin K, Ho E, Iwaniec UT (2007) Impaired osteoinduction in a rat model for chronic alcohol abuse. Bone 41:175–180CrossRefPubMedGoogle Scholar
  12. 12.
    Torricelli P, Fini M, Giavaresi G, Rimondini L, Tschon M, Rimondini R, Carrassi A, Giardino R (2008) Chronic alcohol abuse and endosseous implants: linkage of in vitro osteoblast dysfunction to titanium osseointegration rate. Toxicology 243:138–144CrossRefPubMedGoogle Scholar
  13. 13.
    Stobaugh RH (1992) Status of the hydroxyapatite-coated unilateral subperiosteal implant using direct bone impressions. Dent Clin North Am 36:67–76PubMedGoogle Scholar
  14. 14.
    Friday KE, Howard GA (1991) Ethanol inhibits human bone cell proliferation and function in vitro. Metabolism 40:562–565CrossRefPubMedGoogle Scholar
  15. 15.
    Klein RF (1996) Alcohol-induced bone disease: impact of ethanol on osteoblast proliferation. Alcohol Clin Exp Res 20:572–578CrossRefPubMedGoogle Scholar
  16. 16.
    Sampson HW (2002) Effects of alcohol consumption on adult and aged bone: a histomorphometric study of the rat animal model. Alcohol Clin Exp Res 22:2029–2034Google Scholar
  17. 17.
    Camilli JA, Cunha MR, Bertran CA, Kawachi EY (2004) Subperiosteal hydroxyapatite implants in rats submitted to ethanol ingestion. Arch Oral Biol 44:747–753CrossRefGoogle Scholar
  18. 18.
    Galindo-Moreno P, Fauri M, Ávila-Ortiz G, Fernández-Barbero J, Cabrera-Léon A, Sánchez-Fernández E (2005) Influence of alcohol and tobacco habits on peri-implant marginal bone loss: A prospective study. Clin Oral Implants Res 16:579–586CrossRefPubMedGoogle Scholar
  19. 19.
    Leite A (2001) O tabagismo e a boca. Res da Associação Paulista de Cirurgiões Dentistas 55:7–14Google Scholar
  20. 20.
    Lindiquinst LW, Carlsson GE, Jemt T (1997) Association between marginal bone loss around osseintegrated mandibular implants and smoking habits: A 10-year follow-up study. J Dent Res 76:1667–1674CrossRefGoogle Scholar
  21. 21.
    Sennerby L, Roos J (1998) Surgical determinants of clinical success of osseointegrated oral implants: a review of the literature. Int J Prosthodont 11:408–420PubMedGoogle Scholar
  22. 22.
    Baig MR, Rajan M (2007) Effects of smoking on the outcome of implant treatment: a literature review. Indian J Dent Res 18:190–195CrossRefPubMedGoogle Scholar
  23. 23.
    Fávaro WJ, Cagnon VH (2006) Morphometric and morphological features of the ventral prostate in rats submitted to chronic nicotine and alcohol treatment. Tissue Cell 38:311–323CrossRefPubMedGoogle Scholar
  24. 24.
    Mandarim-de-Lacerda CA (1999) What is the interest of normal and pathological morphological research to be quantitative? The example of the stereology. Braz J Morphol 16:131–139Google Scholar
  25. 25.
    Kang Q, Yuehuei H, Friedman RJ (1997) Effects of multiple freezing-thawing cycles on ultimate indentation load and stiffness of bovine cancellous bone. Am J Vet Res 58:1171–1173PubMedGoogle Scholar
  26. 26.
    Montgomery DC (1991) Design and analysis of experiments. John Wiley, New YorkGoogle Scholar
  27. 27.
    Iwaniec UT, Haynatzki GR, Fung YK, Akhter MP, Haven MC, Cullen DM (2002) Effects of nicotine on bone and calciotropic hormones in aged ovariectomized rats. J Musculoskelet Neuronal Interact 2:469–478PubMedGoogle Scholar
  28. 28.
    Kamer AR, El-Ghorab N, Marzec N, Margarone JE, Dziak R (2006) Nicotine induced proliferation and cytokine release in osteoblastic cells. Int J Mol Med 17:121–127PubMedGoogle Scholar
  29. 29.
    Holbrook TL, Connor EB (1993) A prospective study of alcohol consumption and bone mineral density. BMJ 306:1506–1509CrossRefPubMedGoogle Scholar
  30. 30.
    National Research Council (1995) Nutrient requirements of laboratory animals. National Academy Press, Washington, DC, p 192Google Scholar
  31. 31.
    Marks SC, Popoff SN (1988) Bone cell biology: the regulation of development, structure, and function in the skeleton. Am J Anat 183:2–44CrossRefGoogle Scholar
  32. 32.
    Skott M, Andreassen TT, Ulrich-Vinther M, Chen X, Keyler DE, Lesage MG, Pentel PR, Bechtold JE, Soballe T (2006) Tobacco extract but not nicotine impairs the mechanical strength of fracture healing in rats. J Orthop Res 27:1472–1479CrossRefGoogle Scholar
  33. 33.
    Chakkalakal DA, Novak JR, Fritz ED, Mollner TJ, Mcvicker DL, Garvin KL, Mcguire MH, Donohue TM (2005) Inhibition of bone repair in a rat model for chronic and excessive alcohol consumption. Alcohol 36:201–214CrossRefPubMedGoogle Scholar
  34. 34.
    Kan JY, Rungcharasseng K, Lozada JL, Goodacre CJ (1999) Effects of smoking on implant success in grafted maxillary sinuses. J Prosther Dent 82:307–311CrossRefGoogle Scholar
  35. 35.
    Nociti FH Jr, Neto JBC (2002) Bone density around titanium implants may be influenced by intermittent cigarette smoke inhalation—a histometric study in rats. Int J Oral Maxillofacial Implants 17:347–352Google Scholar
  36. 36.
    Klaassen CD (1996) Agentes tóxicos ambientais não-metálicos. In: Goodman LS, Gilmar S (eds) As Bases Farmacológicas da Terapêutica 9 ed. Mcgraw-Hill Interamericana, Rio de JaneiroGoogle Scholar
  37. 37.
    Yuhara S, Kasagi S, Inoue A, Otsuka E, Hirise S, Hagiwara H (1999) Effects of nicotine on cultured cells suggest that it can influence the formation and resorption of bone. Eur J Pharmacol 383:387–393CrossRefPubMedGoogle Scholar
  38. 38.
    Keiver K, Duggal S, Simpson ME (2005) Ethanol administration results in a prolonged decrease in blood ionized calcium levels in the rat. Alcohol 37:173–178CrossRefPubMedGoogle Scholar
  39. 39.
    Thome JF, Bilezikian JP (1993) Hypocalcemia emergencies. Endocrinol Metab Clin North Am 22:363–375Google Scholar
  40. 40.
    Porto CC (2001) Semiologia Médica 4 ed. Guanabara Koogan, Rio de JaneiroGoogle Scholar
  41. 41.
    Fung YK, Iwaniec U, Cullen DM (1999) Long term effects of nicotine on bone and calciotropic hormones in adult female rats. Pharmacol Toxicol 185:181–187CrossRefGoogle Scholar
  42. 42.
    Riesenfeld A (1985) Growth-depressing effects of alcohol and nicotine in two strains of rats. Acta Anat 122:18–24CrossRefPubMedGoogle Scholar
  43. 43.
    Diez A, Serrano S, Cucurull J, Marinoso LL, Bosh J, Prug J, Nogues X, Aubia J (1997) Acute effects of ethanol on mineral metabolism and trabecular bone in Sprague-Dawley rats. Calcified Tissue Int 61:168–171CrossRefGoogle Scholar
  44. 44.
    Hogan HA, Argueta F, Moe L, Nguyen LP, Sampson HW (2001) Adult-onset alcohol consumption induces osteopenia in female rats. Alcohol Clin Exp Res 25:746–754CrossRefPubMedGoogle Scholar
  45. 45.
    Sylversen U, Nordsletten L, Falch JA, Madsen JE, Nilsen OG, Waldum HL (1999) Effect of lifelong nicotine inhalation on bone mass and mechanical properties in female rats femurs. Calcif Tissue Int 63:246–249CrossRefGoogle Scholar

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer 2009

Authors and Affiliations

  • Evelise V. Soares
    • 1
  • Wagner J. Fávaro
    • 2
  • Valéria H. A. Cagnon
    • 2
  • Celso A. Bertran
    • 3
  • José A. Camilli
    • 2
  1. 1.Department of AnatomyUniversity of José Rosário Vellano (UNIFENAS)AlfenasBrazil
  2. 2.Department of Anatomy, Institute of BiologyUniversity of Campinas (UNICAMP)CampinasBrazil
  3. 3.Institute of ChemistryUniversity of Campinas (UNICAMP)CampinasBrazil

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