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Taha GI. Involvement of IL-10 gene polymorphism (rs1800896) and IL-10 level in the development of periimplantitis. Minerva Dent Oral Sci 2024; 73:264-271. [PMID: 38037697 DOI: 10.23736/s2724-6329.23.04844-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Dental implant loss is the worst problem. Today, implant failure is precisely characterized, however the underlying reasons vary by instance. Multiple implant failures indicate genetic risk factors. METHODS This cross-sectional study included 80 subjects (15 peri-implantitis patients, 35 successful implants and 30 healthy controls); their mean age was 44.22±10.936 years). Blood samples and peri-implant sulcular fluid (PISF) were collected from all subjects (patients with peri-implantitits, successful implants and healthy controls) attending the Department of Oral and Maxillofacial Surgery in the Dental College Teaching Hospital/Baghdad University, and Shahid Ghazi Al-Hariri Hospital/Medical City Baghdad, Iraq. The blood sample is used for the detection of gene polymorphism of Interleukin-10 conducted by a polymerase chain reaction. While the PISF is used to measure IL-10 level by enzyme-linked immunosorbent assay (ELISA). RESULTS In the peri-implantitis group, CC genotypes had higher PISF for IL-10 than TC and TT genotypes (P<0.05). IL-10 genetic polymorphism indicated an odds ratio of genotype related to peri-implantitis, with the C/C genotype having a 0.4-fold greater risk (P=0.0035). In the peri-implantitis group, the T/C genotype had a 1.3-fold greater risk (P<0.05) and the T/T genotype had a one-fold increased risk. CONCLUSIONS The polymorphisms of IL-10 rs1800896 evaluated were not predictive of the failure of dental implants. However, a significant association between peri-implant disease and IL-10 level could be observed.
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Affiliation(s)
- Ghada I Taha
- Department of Basic Sciences, College of Dentistry, University of Baghdad, Baghdad, Iraq -
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2
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Erduran NE, Guncu GN, Akman AC, Acar B, Pinar A, Karabulut E, Nohutcu RM. Evaluation of the effect of adjunctive diode laser application on peri-implant crevicular fluid biomarker levels: a randomized controlled trial. Clin Oral Investig 2024; 28:459. [PMID: 39080143 PMCID: PMC11289239 DOI: 10.1007/s00784-024-05855-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVES To assess both the clinical and immunological effectiveness of diode laser therapy when used as an adjunct to non-surgical mechanical therapy in managing peri-implantitis. MATERIALS AND METHODS A cohort of 27 participants, comprising 21 females and 6 males, agreed to take part in this investigation. 37 dental implants with peri-implantitis diagnosis were randomly allocated to either the laser group (n = 19) or the control group (n = 18). Evaluation of peri-implant clinical parameters and collection peri-implant crevicular fluid (PICF) samples occurred at baseline, as well as at 3 and 6-month follow-up intervals. The level of various biomarkers (TWEAK, IL-1β, sclerostin, IL-17, RANKL, OPG and IL-10) within the PICF were quantified using enzyme-linked immunosorbent assay. RESULTS Significant time-dependent decreases in clinical and biochemical parameters were detected in both groups compared to the baseline. There were marked differences between the groups in terms of periodontal parameters, except probing depth, and IL-1β, IL-17, sclerostin levels in PICF at 3rd month follow-up. However, no statistically significant difference was detected at 6th month. CONCLUSIONS Diode laser seems to be a reliable tool as an adjunct for supporting the nonsurgical mechanical treatment during the early stages of peri-implantitis. Furthermore, the findings suggest that IL-17, sclerostin and IL-1β may serve as promising biomarkers for assessing efficacy of peri-implantitis treatment. CLINICAL RELEVANCE Based on these outcomes, clinicians may consider the application of adjunctive use of diode laser to non-surgical peri-implantitis treatment to achieve better clinical and immunological improvements than nonsurgical peri-implantitis therapy alone in just early healing period. However, it should be noted that there was no difference between the two methods in the long term.
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Affiliation(s)
- Nazan Ece Erduran
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey
| | - Guliz N Guncu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey.
| | - Abdullah C Akman
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey
| | - Buket Acar
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey
| | - Asli Pinar
- Department of Biochemistry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rahime M Nohutcu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, TR-06230, Turkey
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3
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Oliveira JA, de Oliveira Alves R, Nascimento IM, Hidalgo MAR, Scarel-Caminaga RM, Cristina Pigossi S. Pro- and anti-inflammatory cytokines and osteoclastogenesis-related factors in peri-implant diseases: systematic review and meta-analysis. BMC Oral Health 2023; 23:420. [PMID: 37355561 PMCID: PMC10290807 DOI: 10.1186/s12903-023-03072-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/23/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Pro- and anti-inflammatory cytokines are acknowledged, during inflammatory bone destruction, as key regulators of osteoclast and osteoblast differentiation and activity. However, evidence regarding the exact role of pro- and anti-inflammatory cytokines and osteoclastogenesis-related factors in peri-implant diseases is unclear. We aimed to execute a systematic review and meta-analysis about the pro- and anti-inflammatory cytokines and osteoclastogenesis-related factors levels in peri-implant diseases. METHODS The focused question was elaborated to summarize the levels of pro-and anti-inflammatory cytokines and osteoclastogenesis-related factors in tissue samples (mRNA) and biofluids (protein levels) of patients with/without peri-implant diseases. Electronic searches of the PubMed, Cochrane Controlled Trials Registry, Web of Science, EMBASE, Scopus and Google scholar databases were conducted for publications up to March 2023. Meta-analysis evaluating the mediator´s levels (protein levels by ELISA) in peri-implant crevicular fluid (PICF) were made. The effect size was estimated and reported as the mean difference. The 95% confidence interval was estimated for each mediator, and the pooled effect was determined significant if two-sided p-values < 0.05 were obtained. RESULTS Twenty-two publications were included in the systematic review (qualitative analysis), with nine of these subjected to meta-analyses (quantitative analysis). In the qualitative analysis, higher pro-inflammatory cytokines [Interleukin (IL)-1β, IL-6] and pro-osteoclastogenic mediator [Receptor Activator of Nuclear Factor-Kappa B ligand (RANKL)] levels were observed in PICF of individuals with peri-implant diseases in comparison to healthy individuals. Higher RANKL/osteoprotegerin (OPG) ratios were observed in PICF from individuals with peri-implant diseases in comparison to healthy individuals. Meta-analysis showed higher RANKL levels in diseased groups compared to controls. CONCLUSIONS The results showed that the levels of IL-1β, IL-6, IL-10, and RANKL/OPG are not balanced in peri-implant disease, suggesting that these mediators are involved in the host osteo-immunoinflammatory response related to peri-implantitis.
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Affiliation(s)
- Jovânia Alves Oliveira
- School of Dentistry, Alfenas Federal University (Unifal-MG), Alfenas, Minas Gerais Brazil
| | - Roberta de Oliveira Alves
- Department of Periodontology, School of Dentistry, School of Dentistry, Federal University of Uberlândia - UFU, Umuarama Campus, Bloco UMU4L, Pará Avenue, Uberlândia, Minas Gerais 1720, 38405-320 Brazil
| | | | - Marco Antonio Rimachi Hidalgo
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, (FOAr/UNESP), UNESP- São Paulo State University, Araraquara, São Paulo, Brazil
| | - Raquel Mantuaneli Scarel-Caminaga
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, (FOAr/UNESP), UNESP- São Paulo State University, Araraquara, São Paulo, Brazil
| | - Suzane Cristina Pigossi
- Department of Periodontology, School of Dentistry, School of Dentistry, Federal University of Uberlândia - UFU, Umuarama Campus, Bloco UMU4L, Pará Avenue, Uberlândia, Minas Gerais 1720, 38405-320 Brazil
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4
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Malheiros SS, Nagay BE, Bertolini MM, de Avila ED, Shibli JA, Souza JGS, Barão VAR. Biomaterial engineering surface to control polymicrobial dental implant-related infections: focusing on disease modulating factors and coatings development. Expert Rev Med Devices 2023:1-17. [PMID: 37228179 DOI: 10.1080/17434440.2023.2218547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/29/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Peri-implantitis is the leading cause of dental implant loss and is initiated by a polymicrobial dysbiotic biofilm formation on the implant surface. The destruction of peri-implant tissue by the host immune response and the low effectiveness of surgical or non-surgical treatments highlight the need for new strategies to prevent, modulate and/or eliminate biofilm formation on the implant surface. Currently, several surface modifications have been proposed using biomolecules, ions, antimicrobial agents, and topography alterations. AREAS COVERED Initially, this review provides an overview of the etiopathogenesis and host- and material-dependent modulating factors of peri-implant disease. In addition, a critical discussion about the antimicrobial surface modification mechanisms and techniques employed to modify the titanium implant material is provided. Finally, we also considered the future perspectives on the development of antimicrobial surfaces to narrow the bridge between idea and product and favor the clinical application possibility. EXPERT OPINION Antimicrobial surface modifications have demonstrated effective results; however, there is no consensus about the best modification strategy and in-depth information on the safety and longevity of the antimicrobial effect. Modified surfaces display recurring challenges such as short-term effectiveness, the burst release of drugs, cytotoxicity, and lack of reusability. Stimulus-responsive surfaces seem to be a promising strategy for a controlled and precise antimicrobial effect, and future research should focus on this technology and study it from models that better mimic clinical conditions.
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Affiliation(s)
- Samuel S Malheiros
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Bruna E Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Martinna M Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15106, USA
| | - Erica D de Avila
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araçatuba, São Paulo State University (UNESP), Araçatuba, Sao Paulo 16015-050, Brazil
| | - Jamil A Shibli
- Dental Research Division, Guarulhos University, Guarulhos, São Paulo 07023-070, Brazil
| | - João Gabriel S Souza
- Dental Research Division, Guarulhos University, Guarulhos, São Paulo 07023-070, Brazil
- Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais39401-303, Brazil
| | - Valentim A R Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
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Puisys A, Janda M, Auzbikaviciute V, Gallucci G, Mattheos N. Contour angle and peri-implant tissue height: Two interrelated features of the implant supracrestal complex. Clin Exp Dent Res 2023. [PMID: 36988518 DOI: 10.1002/cre2.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/01/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES Recent research has suggested the contour of the prosthesis and the vertical height of the peri-implant mucosa as important parameters that can influence the long term health and stability of the peri-implant tissue. In particular, overcontouring of the prosthesis has been correlated with an increased risk for peri-implantitis, while reduced soft tissue height has been associated with marginal bone loss, recession, and other soft tissue complications. Although these two parameters have been investigated as independent in the current literature, clinical experience points toward a close interrelation between transmucosal tissue height and prosthesis contour angle. It is often found that a reduced vertical height of the implant supracrestal complex is the main reason for overcontouring of the prosthesis. At the same time, achieving a favorable contour of 30o or less is not possible unless the clinician has ensured an adequate vertical height of the soft tissue. The purpose of this short communication is to establish the relation between tissue vertical height and prosthesis contour by utilizing a theoretical geometry equation based on the Pythagorean theorem. In doing so, one can use the dimensions of the implant as well as those of the prosthesis at the mucosal margin to calculate the essential vertical height for achieving a favorable prosthesis contour. CONCLUSIONS As the treatment plan of the implant supracrestal complex is "top-down," in case of deficient vertical height, subcrestal placement of the implant should be considered to achieve a proper prosthesis contour.
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Affiliation(s)
| | - Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmoe University, Malmö, Sweden
| | | | - German Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, School of Dental Medicine Harvard University, Boston, Massachusetts, USA
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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6
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Analysis of Biomarkers and Marginal Bone Loss in Platform-Switched and Nonplatform-Switched Implants: A Randomized Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2603287. [PMID: 35637753 PMCID: PMC9148225 DOI: 10.1155/2022/2603287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/22/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022]
Abstract
Objectives. To compare the peri-implant crevicular fluid (PICF) biomarker levels, peri-implant status, and marginal bone level (MBL) differences of implants restored with randomly assigned nonplatform-switched (NPS) or platform-switched (PS) abutments. Methods. Ninety-four implants in 27 subjects were included in this study. Receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin-1β (IL-1β), monocyte chemotactic protein-1 (MCP-1) levels in PICF, peri-implant health, and the change in the MBL were evaluated at the time of restoration (
) and after 12 months (
). Results. The IL-1β levels decreased and the RANKL, OPG, and MCP-1 levels increased from
to
(
) in both groups. RANKL/OPG ratio at
, MCP-1 levels at
, and the MCP-1 change from
to
were lower in the PS group than in the NPS group (
). MBL change was lower (
mm) in the PS group than that (
mm) in the NPS group at
(
). Peri-implant health status between the study groups was negligible. Conclusion. PS was superior to NPS regarding the preservation of MBL. Higher MCP-1 levels, altered RANKL/OPG ratio, and lower OPG levels in the NPS group could be associated with subclinical peri-implant bone remodeling.
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Kniha K, Rink L, Wolf J, Möhlhenrich SC, Peters F, Heitzer M, Hölzle F, Modabber A. Host inflammatory response and clinical parameters around implants in a rat model using systemic alendronate and zoledronate acid drug administrations. Sci Rep 2022; 12:4431. [PMID: 35292688 PMCID: PMC8924183 DOI: 10.1038/s41598-022-08308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 02/22/2022] [Indexed: 11/16/2022] Open
Abstract
Implant outcomes in comparison to a natural tooth in a rat model using systemic alendronate and zoledronate acid drug administrations were assessed. Fifty-four Sprague–Dawley rats were randomly allocated into two experimental groups (drug application of zoledronic acid; 0.04 mg/kg intravenously once a week and alendronic acid; 0.2 mg/kg subcutaneously five times a week) and one control group with 18 animals in each group. Drug delivery was conducted for a period of 4 months. After 4 weeks either a zirconia or a titanium implant was immediately inserted in the socket of the first molar of the upper jaw. In vivo investigations included host inflammatory parameters and the implant survival and success rates for up to 3 months. Material incompatibilities against titanium and zirconia nanoparticles were evaluated in vitro after stimulation of rat spleen cells. In vivo, IL-6 release around titanium implants demonstrated significantly higher values in the control group (p = 0.02) when compared to the zoledronic acid group. Around the natural tooth without drug administration, the control group showed higher IL-6 values compared with the alendronic acid group (p = 0.01). In vitro, only lipopolysaccharide and not the implant’s nanoparticles stimulated significant IL-6 and TNFα production. In terms of the primary aim of in vivo and in vitro IL-6 and TNFα measurements, no implant material was superior to the other. No significant in vitro stimulation of rat spleen cells was detected with respect to titanium oxide and zirconium oxide nanoparticles.
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Affiliation(s)
- Kristian Kniha
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, University Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Lothar Rink
- Institute of Immunology, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen, Germany
| | - Jana Wolf
- Institute of Immunology, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen, Germany
| | | | - Florian Peters
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, University Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marius Heitzer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, University Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, University Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, University Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Theodoridis C, Doulkeridou C, Menexes G, Vouros I. Comparison of RANKL and OPG levels in peri-implant crevicular fluid between healthy and diseased peri-implant tissues. A systematic review and meta-analysis. Clin Oral Investig 2021; 26:823-836. [PMID: 34264378 DOI: 10.1007/s00784-021-04061-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/28/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To assess RANKL and OPG levels, as well as RANKL/OPG ratio, in peri-implant crevicular fluid (PICF), in dental implants presenting peri-implantitis (PI) in comparison to healthy implants (H) and to implants with peri-implant mucositis (MU). MATERIALS AND METHODS An electronic search based on the PICO framework, supplemented by hand searching, was conducted in MEDLINE and EMBASE, using the Ovid interface from 1996 up to and including the 17th of December 2019 in order to identify relevant clinical studies. A combination of MeSH terms and text words was utilized for this purpose. Sequential screenings at the title, abstract, and full-text levels were performed independently and in duplicate. A random-effects meta-analysis was conducted and mean value standardized differences, between PI and H groups, were utilized as effect sizes. RESULTS Out of 1961 titles, which were revealed by the search strategy, 11 articles fulfilled the inclusion criteria and were incorporated in the systematic review. Meta-analytical processing was performed for RANKL (4 articles), OPG (5 articles), and RANKL/OPG ratio (5 articles) in PI and H groups. The total effect for RANKL mean differences between PI and H groups indicated a tendency but not a statistical significance (P = 0.078) in favor of the PI group, while no statistically significant differences were found for OPG and the ratio levels in the examined groups. CONCLUSIONS There is limited evidence that levels of the examined biomarkers, RANKL, and OPG as well as the RANKL/OPG ratio, in PICF, may be considered strong indicators for distinguishing between healthy and inflamed peri-implant sites. CLINICAL RELEVANCE Biomarker identification in PICF, which could differentiate between healthy and diseased dental implants, might represent a valuable non-invasive method suitable for implant pathology and implant therapy prognosis.
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Affiliation(s)
- C Theodoridis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.,Cretan District Health Directorate, Agia Foteini Health Center, Rethymnon, Greece
| | - C Doulkeridou
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - G Menexes
- Laboratory of Agronomy, School of Agriculture, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Vouros
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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Aleksandrowicz P, Brzezińska-Błaszczyk E, Kozłowska E, Żelechowska P, Borgonovo AE, Agier J. Analysis of IL-1β, CXCL8, and TNF-α levels in the crevicular fluid of patients with periodontitis or healthy implants. BMC Oral Health 2021; 21:120. [PMID: 33726736 PMCID: PMC7968186 DOI: 10.1186/s12903-021-01478-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/03/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Our study aimed to assess the level of IL-1β, CXCL8, and TNF-α in peri-implant sulcular fluid (PISF) collected from patients with no clinical symptoms of mucositis or peri-implantitis and compare them with cytokine concentration in gingival crevicular fluid (GCF) acquired from patients with healthy periodontium and those with varying severity of periodontitis. METHODS A total of 189 subjects were included in the study, and GCF/PISF samples were checked for IL-1β, CXCL8, and TNF-α levels using an ELISA test. RESULTS The IL-1β level in PISF in patients with implants was significantly lower than in GCF in patients with mild, moderate, or severe periodontitis. The CXCL8 level in PISF was considerably lower than in patients with moderate periodontitis. The TNF-α level in PISF in patients with implants was markedly higher compared to subjects with healthy periodontium or patients with mild periodontitis. CONCLUSION Analysis of cytokine levels may help describe the pathogenesis and early diagnosis of peri-implantitis and prevision in high-risk patients.
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Affiliation(s)
| | | | - Elżbieta Kozłowska
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland
| | - Paulina Żelechowska
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland
| | | | - Justyna Agier
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland.
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10
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Russell T, Bridgewood C, Rowe H, Altaie A, Jones E, McGonagle D. Cytokine "fine tuning" of enthesis tissue homeostasis as a pointer to spondyloarthritis pathogenesis with a focus on relevant TNF and IL-17 targeted therapies. Semin Immunopathol 2021; 43:193-206. [PMID: 33544244 PMCID: PMC7990848 DOI: 10.1007/s00281-021-00836-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022]
Abstract
A curious feature of axial disease in ankylosing spondylitis (AS) and related non-radiographic axial spondyloarthropathy (nrAxSpA) is that spinal inflammation may ultimately be associated with excessive entheseal tissue repair with new bone formation. Other SpA associated target tissues including the gut and the skin have well established paradigms on how local tissue immune responses and proven disease relevant cytokines including TNF and the IL-23/17 axis contribute to tissue repair. Normal skeletal homeostasis including the highly mechanically stressed entheseal sites is subject to tissue microdamage, micro-inflammation and ultimately repair. Like the skin and gut, healthy enthesis has resident immune cells including ILCs, γδ T cells, conventional CD4+ and CD8+ T cells and myeloid lineage cells capable of cytokine induction involving prostaglandins, growth factors and cytokines including TNF and IL-17 that regulate these responses. We discuss how human genetic studies, animal models and translational human immunology around TNF and IL-17 suggest a largely redundant role for these pathways in physiological tissue repair and homeostasis. However, disease associated immune system overactivity of these cytokines with loss of tissue repair “fine tuning” is eventually associated with exuberant tissue repair responses in AS. Conversely, excessive biomechanical stress at spinal enthesis or peripheral enthesis with mechanically related or degenerative conditions is associated with a normal immune system attempts at cytokine fine tuning, but in this setting, it is commensurate to sustained abnormal biomechanical stressing. Unlike SpA, where restoration of aberrant and excessive cytokine “fine tuning” is efficacious, antagonism of these pathways in biomechanically related disease may be of limited or even no value.
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Affiliation(s)
- Tobias Russell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Charlie Bridgewood
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Hannah Rowe
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Ala Altaie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Elena Jones
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Dennis McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK.
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, UK.
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11
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Immunological Aspects of Dental Implant Rejection. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7279509. [PMID: 33376734 PMCID: PMC7744195 DOI: 10.1155/2020/7279509] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/29/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
Nowadays, dental implants are a prominent therapeutic approach among dentists for replacing missing teeth. Failure in dental implants is a severe challenge recently. The factors which lead to dental implant failure are known. These factors can be categorized into different groups. In this article, we discussed the immunological aspects of implant failure as one of these groups. Cytokines and immune cells have extensive and various functions in peri-implantitis. The equilibrium between pro and anti-inflammatory cytokines and cells, which involve in this orchestra, has a crucial role in implant prognosis. In conclusion, immune cells, especially macrophages and dendritic cells, almost increased in the patients with implant failure. Also, proinflammatory cytokines were proposed as diagnostic factors according to their higher levels in dental implant rejection.
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12
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Yuan Y, Zhang H, Huang H. microRNAs in inflammatory alveolar bone defect: A review. J Periodontal Res 2020; 56:219-225. [PMID: 33296525 DOI: 10.1111/jre.12819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/24/2020] [Accepted: 10/28/2020] [Indexed: 01/12/2023]
Abstract
Inflammatory alveolar bone defects are caused by periodontal pathogens, are one of the most common oral diseases in the clinic, and are characterized by periodontal support tissue damage. MicroRNAs (miRNAs) can participate in a variety of inflammatory lesions and modulate bone metabolism through the posttranscriptional regulation of target genes. In recent years, studies have confirmed that some miRNAs play significant roles in the development of inflammatory alveolar bone defects. Therefore, we reviewed the correlation between miRNAs and inflammatory alveolar bone defects and elucidated the underlying mechanisms to provide new ideas for the prevention and treatment of inflammatory alveolar bone defects.
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Affiliation(s)
- Yun Yuan
- Department of Prosthodontics, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center of Stomatology, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Hongming Zhang
- Department of Prosthodontics, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center of Stomatology, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Hui Huang
- Department of Prosthodontics, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center of Stomatology, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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13
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Cheng GL, Leblebicioglu B, Li J, Chien HH. Soft tissue healing around platform-switching and platform-matching single implants: A randomized clinical trial. J Periodontol 2020; 91:1609-1620. [PMID: 32474935 DOI: 10.1002/jper.20-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/16/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Implants with platform-switching (PS) design have been demonstrated to reduce marginal bone loss. However, the influence on peri-implant soft tissue healing is unclear. This study was designed to investigate its effect on peri-implant soft tissue healing after implant uncovery. METHODS Non-smokers needing two implants in different quadrants were recruited in this study. For each individual, one PS and one platform-matching (PM) implants were placed using two-stage protocol. Following 2 to 8 months of healing, all implants were uncovered and connected to the corresponding healing abutments. Clinical measurements and peri-implant crevicular fluid (PICF) were taken at 1-, 2-, 4-, and 6-week after 2nd stage surgery. The cytokine concentrations in PICF were analyzed. Peri-implant mucosa (1 × 2 × 2 mm) was harvested around the healing abutment for the analysis of gene expression at uncovery and 6-week post-uncovery. RESULTS Eighteen participants (nine males; 51.7 ± 14.9 years) were recruited. Compared to PM, PS showed significantly lower probing depth (PD) at 1- and 2-week as well as modified sulcus bleeding index (mSBI) at 1-, 4-, and 6-week (P < 0.05). Over time, a decrease in osteoprotegerin and interleukin-1β concentrations in PICF along with an increase in receptor activator of unclear factor kappa-B ligand, periostin, and peroxidasin gene expressions in peri-implant mucosa were noted within both groups (P < 0.05) without significant intergroup differences. CONCLUSION Within the limits, implants with PS design rendered significant benefits over PM design in PD and mSBI reduction during a 6-week healing. However, molecular changes within PICF and peri-implant mucosa as a response to PM and PS appear negligible.
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Affiliation(s)
- Guo-Liang Cheng
- Graduate Periodontics, Department of Oral Health and Rehabilitation, School of Dentistry, University of Louisville, Louisville, Kentucky, USA.,Division of Periodontics, Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan
| | - Binnaz Leblebicioglu
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Jianrong Li
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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14
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Spitz A, Teles RP, Nojima LI. Influence of orthodontic loading on biomarkers levels around miniscrews. Arch Oral Biol 2020; 112:104668. [PMID: 32032909 DOI: 10.1016/j.archoralbio.2020.104668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/06/2020] [Accepted: 01/15/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the levels of Interleukin-1α (IL-1α), Interleukin-1β (IL-1β), Interleukin-1 receptor antagonist (IL-1Ra), Interleukin-10 (IL-10), Interleukin-13 (IL-13), Vascular endothelial growth factor (VEGF), Granulocyte-colony stimulating factor (G-CSF), and Growth related oncogene (GRO) in the peri-miniscrew implant crevicular fluid (MICF) under orthodontic loading. DESIGN The study sample comprised 14 miniscrews immediately loaded and 17 unloaded ones. A load of 200gF was immediately applied to the miniscrews in the loaded group after the placement surgery. Peri-miniscrew implant crevicular fluid was collected at baseline, at day 7, and at day 21. The levels of the biomarkers were measured using a multiplexed bead immunoassay. Intergroup comparisons were made using Mann-Whitney test. Friedman and Dunn's multiple comparison tests were used to evaluate intragroup differences over time. RESULTS Although no statistical differences were observed between the groups at any time point for any of the 8 biomarkers evaluated, there was a statistically significant increase (p < 0.02) in the levels of all the biomarkers over time on both groups. CONCLUSIONS An immediate loading of 200gF does not alter the balance in the inflammatory response in peri-miniscrew tissues.
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Affiliation(s)
- Alice Spitz
- Department of Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Ricardo Palmier Teles
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, USA
| | - Lincoln Issamu Nojima
- Department of Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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15
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Presence of ROS in Inflammatory Environment of Peri-Implantitis Tissue: In Vitro and In Vivo Human Evidence. J Clin Med 2019; 9:jcm9010038. [PMID: 31878038 PMCID: PMC7019824 DOI: 10.3390/jcm9010038] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/17/2022] Open
Abstract
Analyses of composition, distribution of cellular and extracellular matrix components, and molecular analysis of mitochondria related genes of bone loss in the presence of inflammatory environment in humans was the aim of the present project. As a human model we chose peri-implantitis. Morphological analyses were performed by means classical histological, immunohistochemical, and SEM (scanning electron miscroscopy) test. Gene expression analysis was performed to evaluate epithelium maturation, collagen fiber production, and genes related to mitochondrial activity. It was found that a well-defined keratinocyte epithelium was present on the top of all specimens; a distinct basal lamina was present, as well as desmosomes and autophagic processes related to the maturation of keratinocytes. Under this epithelium, a full inflammatory cell infiltrate was present for about 60% of the represented by plasma cells. Collagen type I fibers were present mainly in the form of fragmented cord tissue without cells. A different distribution of blood vessels was also present from the apical to the most coronal portion of the specimens. High levels of genes related to oxidative stress were present, as well as the activation of genes related to the loss of ability of osteogenic commitment of Mesenchymal stem cells into osteoblasts. Our study suggests that peri-implantitis lesions exhibit a well defined biological organization not only in terms of inflammatory cells but also on vessel and extracellular matrix components even if no difference in the epithelium is evident, and that the presence of reactive oxygen species (ROS) related to the inflammatory environment influences the correct commitment of Mesenchymal stem cells.
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16
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Carinci F, Romanos GE, Scapoli L. Molecular tools for preventing and improving diagnosis of peri-implant diseases. Periodontol 2000 2019; 81:41-47. [PMID: 31407432 DOI: 10.1111/prd.12281] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Peri-implantitis is an inflammatory disease of tissues surrounding osseointegrated dental implants. Inflammation affecting soft and hard peri-implant tissues can cause alveolar bone resorption and subsequent implant loss. Clinical surveillance and early diagnosis are of paramount importance to reduce clinical failures and improve implant survival. Current diagnosis of implants is based on clinical and radiological signs. Molecular tests are an emerging diagnostic methodology, which potentially can help to detect and prevent early peri-implantitis and monitor the efficacy of therapy as well. A plethora of potential biomarkers are potentially available to support the clinical diagnosis of peri-implantitis. However, conflicting diagnostic conclusions have been reached, probably related to weak statistical results due to limited sample size or disease heterogeneity. The present paper reviews candidate diagnostic biomarkers for peri-implantitis, including infective agents, genetic susceptibility factors, and key proteins related to inflammation and tissue remodeling.
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Affiliation(s)
- Francesco Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Luca Scapoli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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17
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Andrucioli MCD, Matsumoto MAN, Fukada SY, Saraiva MCP, Bergamo AZN, Romano FL, Silva RABD, Silva LABD, Nelson-Filho P. Quantification of pro-inflammatory cytokines and osteoclastogenesis markers in successful and failed orthodontic mini-implants. J Appl Oral Sci 2019; 27:e20180476. [PMID: 31596364 PMCID: PMC6768117 DOI: 10.1590/1678-7757-2018-0476] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/08/2019] [Indexed: 11/22/2022] Open
Abstract
Objectives: Miniscrew has been frequently used, considering that anchorage control is a critical point in orthodontic treatment, and its failure, the main adverse problem. Using two groups of stable (successful) and unstable (failed) mini-implants, this in vivo study aimed to quantify proinflammatory cytokines IL-1 α, IL-6, IL-17, and TNF-α and osteoclastogenesis marker RANK, RANKL, and OPG in gingival tissue, using the real-time polymerase chain reaction technique. Methodology: Thirteen patients of both sexes (11-49 years old) under orthodontic treatment were selected, obtaining 11 successful and 7 failed mini-implants. The mini-implants were placed and removed by the same surgeon, in both jaws. The mean time of permanence in the mouth was 29.4 months for successful and 7.6 months for failed mini-implants. At removal time, peri-mini-implant gingival tissue samples were collected and processed for quantification of the proinflammatory cytokines and osteoclastogenesis markers. Nonparametric Wilcoxon rank-sum test considering the clusters and Kruskal-Wallis test were used for statistical analysis (α=0.05). Results: No significant difference (p>0.05) was observed between the groups for either quantification of cytokines or osteoclastogenesis markers, except for IL-6 (p<0.05). Conclusions: It may be concluded that the expression of IL-1α, IL-17, TNF-α, RANK, RANKL, and OPG in peri-implant gingival tissue were not determinant for mini-implant stability loss, but the higher IL-6 expression could be associated with mini-implant failure.
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Affiliation(s)
- Marcela Cristina Damião Andrucioli
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Mírian Aiko Nakane Matsumoto
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Sandra Yasuyo Fukada
- Universidade de São Paulo, Faculdade de Ciências Famacêuticas de Ribeirão Preto, Departamento de Física e Química, Ribeirão Preto, São Paulo, Brasil
| | - Maria Conceição Pereira Saraiva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Ana Zilda Nazar Bergamo
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Fábio Lourenço Romano
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Raquel Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Lea Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Paulo Nelson-Filho
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
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Corrêa MG, Pimentel SP, Ribeiro FV, Cirano FR, Casati MZ. Host response and peri-implantitis. Braz Oral Res 2019; 33:e066. [PMID: 31576950 DOI: 10.1590/1807-3107bor-2019.vol33.0066] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/18/2022] Open
Abstract
Considering the absence of predictable and effective therapeutic interventions for the treatment of peri-implantitis, scientific evidence concerning the host response profile around dental implants could be important for providing in the future a wider preventive and/or therapeutic window for this peri-implant lesion, indicating biomarkers that provide quantifiable measure of response to peri-implant therapy. Moreover, a better knowledge of pattern of host osteo-immunoinflammatory modulation in the presence of peri-implantitis could either benefit the early diagnostic of the disease or to cooperate to prognostic information related to the status of the peri-implant breakdown. Finally, new evidences concerning the host profile of modulators of inflammation and of osseous tissue metabolism around dental implants could explain the individual susceptibility for developing peri-implant lesions, identifying individuals or sites with increased risk for peri-implantitis. The focus of this chapter was, based on a systematically searched and critically reviewed literature, summarizing the existing knowledge in the scientific research concerning the host osteo-immunoinflammatory response to the microbiological challenge related to periimplantitis.
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Affiliation(s)
- Monica Grazieli Corrêa
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Suzana Peres Pimentel
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Fernanda Vieira Ribeiro
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Fabiano Ribeiro Cirano
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Marcio Zaffalon Casati
- Universidade Paulista - UNIP, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
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19
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Clever K, Schlegel KA, Kniha H, Conrads G, Rink L, Modabber A, Hölzle F, Kniha K. Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 1—host-derived immunological parameters. Int J Oral Maxillofac Surg 2019; 48:554-559. [DOI: 10.1016/j.ijom.2018.10.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 01/07/2023]
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20
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Albaker AM, ArRejaie AS, Alrabiah M, Al-Aali KA, Mokeem S, Alasqah MN, Vohra F, Abduljabbar T. Effect of antimicrobial photodynamic therapy in open flap debridement in the treatment of peri-implantitis: A randomized controlled trial. Photodiagnosis Photodyn Ther 2018; 23:71-74. [DOI: 10.1016/j.pdpdt.2018.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 04/26/2018] [Accepted: 05/04/2018] [Indexed: 02/07/2023]
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21
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Akman AC, Buyukozdemir Askin S, Guncu GN, Nohutcu RM. Evaluation of gingival crevicular fluid and peri-implant sulcus fluid levels of periostin: A preliminary report. J Periodontol 2018; 89:195-202. [PMID: 28914595 DOI: 10.1902/jop.2017.170315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/16/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND Periostin is a protein present in alveolar bone and periodontal ligament whose function is related to response to external forces. The aims of this study are to detect levels of periostin in peri-implant sulcular fluid (PISF) and gingival crevicular fluid (GCF) and to evaluate the relationship between periostin, pyridinoline cross-linked carboxyterminal telopeptide of Type I collagen (ICTP), and C-terminal cross-linked telopeptide of Type I collagen (CTX) levels and clinical inflammatory symptoms and duration of functional loading. METHODS The study population comprised nine women and four men with mean age 43.23 ± 12.48. Twenty "bone-level designed" dental implants (DIs) placed in molar or premolar sites, without any signs of peri-implant bone loss and with a restoration in function for at least 12 months, were included in the study with 20 contralateral natural teeth (NT) as controls. Clinical parameters and restoration dates of the implants were recorded. PISF, GCF, ICTP, CTX, and periostin levels were evaluated using enzyme-linked immunosorbent assay. RESULTS ICTP, CTX, and periostin levels were similar between DI and NT groups. There were no statistically significant differences between PISF and GCF values. When implants were grouped as healthy (gingival index [GI] = 0) and inflamed (GI ≥0), ICTP levels and PISF volume were lower in healthy implants compared with the inflamed group. Both periostin and CTX levels were negatively correlated with functioning time, suggesting less bone remodeling around DIs at later stages of functioning. CONCLUSION Findings of this study suggest collagen breakdown products may be used as markers to evaluate peri-implant metabolism.
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Affiliation(s)
- Abdullah C Akman
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | | | - Guliz N Guncu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Rahime M Nohutcu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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22
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Talo Yildirim T, Acun Kaya F, Yokus B, Colak M, Ozdemir Kaya E, Tekin G, Saribas E, Uysal E, Guncu GN. Associations of alveolar bone loss and interleukin-1β levels in one- and two-stage surgical procedures: a randomized prospective trial. Acta Odontol Scand 2017; 75:608-615. [PMID: 28826290 DOI: 10.1080/00016357.2017.1367959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Dental implants have been widely and successfully used in recent years as an alternative treatment for removable and fixed dental prostheses. The aim of this randomized prospective study was to determine the alveolar bone loss rate (ABLR) and IL-1β levels in one- and two-stage surgical procedures. MATERIALS AND METHODS This study included 40 patients with a single missing tooth in the posterior mandible; dental implants were inserted using a one-stage surgical procedure (Group I) or a two-stage surgical procedure (Group II). All clinical periodontal parameters were recorded; peri-implant crevicular fluid (PICF) samples were collected before loading (T0) and during the third (T1) and sixth (T2) months after loading. ABLR values were evaluated at T0 and T2 by using dental tomography. PICF was analysed after T2 samples were collected. The study was registered through clinicaltrials.gov; identifier NCT03045458. RESULTS This study found that, the probing pocket depth was found to be significantly higher in Group I than Group II at both T1 and T2 (p < .05). There was no significant difference in other clinical parameters between the groups (p > .05). There was a significant difference between Group I ABLR values at T0 and T2 (p < .05). The PICF IL-1β levels were not significantly different between groups (p > .05). CONCLUSIONS Within the limitations of the short observational period and small sample size of this study, two-stage implant placement shows comparable clinical outcomes to implants placed using a one-stage placement protocol.
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Affiliation(s)
- Tuba Talo Yildirim
- Department of Periodontology, Faculty of Dentistry, Firat University, Elazig, Turkey
| | - Filiz Acun Kaya
- Department of Periodontology, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - Beran Yokus
- Department of Biochemistry, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Mehmet Colak
- Department of Dento-Maxillofacial Radiology, Faculty of Dentistry, Dicle University, Dicle University, Diyarbakir, Turkey
| | | | - Giray Tekin
- Diyarbakir Mouth and Teeth Health Center, Diyarbakir, Turkey
| | - Ebru Saribas
- Department of Periodontology, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - Ersin Uysal
- Department of Technics Programs, Diyarbakir Vocational High School, Dicle University, Diyarbakir, Turkey
| | - Guliz N. Guncu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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23
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Bielemann AM, Marcello-Machado RM, Leite FRM, Martinho FC, Chagas-Júnior OL, Antoninha Del Bel Cury A, Faot F. Comparison between inflammation-related markers in peri-implant crevicular fluid and clinical parameters during osseointegration in edentulous jaws. Clin Oral Investig 2017; 22:531-543. [PMID: 28710652 DOI: 10.1007/s00784-017-2169-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 06/26/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The aim of this study is to improve the understanding of interleukin mechanisms during osseointegration to enhance the monitoring of implant failure and success. Clinical parameters, implant stability, and cytokine levels in peri-implant crevicular fluid (PICF) during early bone healing after implant placement were investigated. MATERIAL AND METHODS Sixty narrow implants were placed in mandible anterior region of 30 edentulous patients (67.23 ± 7.66 years). Bone type, insertion torque, and primary stability were registered during surgery. Clinical measurements of peri-implant health and the secondary implant stability quotient (ISQ) were recorded. Samples from the PICF were collected 1, 2, 4, 8, and 12 weeks after surgery and analyzed for IL-1β, IL-6, IL-10, and TNF-α levels using ELISAs. RESULTS The gingival index increased significantly during the first week (p = 0.05), while the plaque index increased significantly between 4 to 8 and 8 to 12 weeks (p < 0.05). The probing depth and the ISQ also reduced significantly (p < 0.05) over time. The TNF-α release increased significantly after the 2nd week for non-atrophic patients and 4th week for atrophic patients (p < 0.05). The IL-1β concentrations showed a short-lived peak after 1st week (p = 0.003), specially in atrophic patients and sites with bone type I (p = 0.034; p = 0.007). The IL-6 concentrations peaked during the 1st and 2nd weeks (p < 0.05; p = 0.005) in atrophic patients and in bone type II (p = 0.023; p = 0.003). The IL-10 concentrations increased gradually over time, showing the highest concentrations at the 12th week (p < 0.005). A total of 12 implants failed at different periods. CONCLUSION While the clinical measurements presented differences between the evaluation periods, these were not indicative of early dental implant failure or peri-implant diseases. Smoking, bone atrophy, and bone type can greatly influence the cytokines concentrations during the healing time.
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Affiliation(s)
| | | | | | - Frederico Canato Martinho
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry, State University of São Paulo, São José dos Campos, SP, Brazil
| | - Otacílio Luiz Chagas-Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and Periodontology, School of Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, RS, 96015-560, Brazil.
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24
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Zani SR, Moss K, Shibli JA, Teixeira ER, de Oliveira Mairink R, Onuma T, Feres M, Teles RP. Peri-implant crevicular fluid biomarkers as discriminants of peri-implant health and disease. J Clin Periodontol 2016; 43:825-32. [PMID: 27279264 DOI: 10.1111/jcpe.12586] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 01/02/2023]
Abstract
AIM The objective of this cross-sectional study was to examine the potential of peri-implant crevicular fluid (PICF) analytes to discriminate between peri-implant health and disease using a multi-biomarker approach. METHODS We collected PICF samples from the mesio-buccal site of every implant (n = 145) from 52 subjects with peri-implantitis and measured the levels of 20 biomarkers using Luminex. We grouped implants and subjects based on the clinical characteristic of the sampled sites and implants into: healthy sites from healthy implants (HH), diseased sites from diseased implants (DD) and healthy sites from diseased implants (HD). The significance of the differences between the HH and DD groups was determined using general linear models controlling for false discovery rate. We used logistic regression to determine the best multi-biomarker models that could distinguish HH from DD subjects and HH from HD subjects. RESULTS There were statistically significant differences between HH and DD groups for 12/20 biomarkers. Logistic regression resulted in a 6-biomarker model (Flt-3L, GM-CSF, IL-10, sCD40L, IL-17 and TNFα) that discriminated HH from DD subjects (AUC = 0.93) and a 3-biomarker model (IL-17, IL-1ra and vascular endothelial growth factor) that distinguished HH from DD subjects (AUC = 0.90). CONCLUSION PICF biomarkers might help discriminate peri-implant health from disease.
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Affiliation(s)
- Sabrina Rebollo Zani
- Department of Prosthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kevin Moss
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Eduardo Rolim Teixeira
- Department of Prosthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Tatiana Onuma
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Ricardo Palmier Teles
- Department of Periodontology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA.
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Dursun E, Tözüm TF. Peri-Implant Crevicular Fluid Analysis, Enzymes and Biomarkers: a Systemetic Review. J Oral Maxillofac Res 2016; 7:e9. [PMID: 27833734 PMCID: PMC5100649 DOI: 10.5037/jomr.2016.7309] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/19/2016] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To review the current understanding of the biomarkers and enzymes associated with different forms peri-implant diseases and how their level changes influence the pathogenesis of the inflammatory diseases around dental implants. MATERIAL AND METHODS An electronic search in two different databases was performed including MEDLINE (PubMed) and EMBASE between 1996 to 2016. Human studies analyse peri-implant crevicular fluid (PICF) biomarker and enzyme levels of implants having peri-implant mucositis and peri-implantitis published in English language, were evaluated. A systematic review was performed to assess which biomarkers and enzymes in PICF were used to identify the inflammatory conditions around dental implants. RESULTS Fifty-one articles were identified of which 41 were further evaluated and included in the analysis. Due to significant heterogeneity between included studies, a meta-analysis could not be performed. Instead, a systematic descriptive review was performed. CONCLUSIONS Biomarkers and enzymes in peri-implant crevicular fluid have shown promising results in differentiating from peri-implant disease condition to health. However, due to inconsistent results and acquiring much evidence from cross-sectional studies, additional evidence supported by randomized-controlled trials is needed to validate the links reported.
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Affiliation(s)
- Erhan Dursun
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, AnkaraTurkey.
| | - Tolga Fikret Tözüm
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IllinoisUSA.
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Meyer S, Giannopoulou C, Courvoisier D, Schimmel M, Müller F, Mombelli A. Experimental mucositis and experimental gingivitis in persons aged 70 or over. Clinical and biological responses. Clin Oral Implants Res 2016; 28:1005-1012. [PMID: 27333829 PMCID: PMC5599942 DOI: 10.1111/clr.12912] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 11/29/2022]
Abstract
Objectives To compare in persons aged 70 years or older the clinical and inflammatory changes occurring around implants and natural teeth during and after a phase of undisturbed plaque accumulation. Material and methods Twenty partially edentulous participants with titanium implants refrained from oral hygiene practices while being clinically monitored in weekly intervals for 21 days. Teeth and implants were then cleaned, oral hygiene resumed, and the participants were further monitored for 3 weeks. Twelve biomarkers were assessed in gingival and peri‐implant crevicular fluid (GCF, PCF). Results During 3 weeks of oral hygiene abstention, the gingival index (GI) continuously increased. On day 21, there were significantly more sites with GI >1 at implants than at teeth. After restarting oral hygiene, the GI decreased markedly in both groups. Throughout the experiment, the plaque index was significantly higher on teeth than on implants. The different biomarkers reacted variably. IL‐1β increased significantly with plaque accumulation. IL‐1β, GM‐CSF, TNF‐α, and IFN‐γ were significantly higher in GCF compared to PCF at day 21. IL‐8 decreased significantly in GCF up to day 14. MIP‐1β decreased significantly in GCF, but not in PCF. At the 3‐week follow‐up, the levels of all biomarkers assessed in GCF and PCF had returned to baseline values. Conclusions In an elderly cohort, plaque accumulation induced an inflammatory reaction around both teeth and implants. Although there was less plaque accumulation on implants, the peri‐implant mucosa showed a stronger clinical response than gingiva.
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Affiliation(s)
- Simon Meyer
- School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | | | - Martin Schimmel
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Frauke Müller
- School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrea Mombelli
- School of Dental Medicine, University of Geneva, Geneva, Switzerland
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Acharya A, Koh ML, Kheur S, Watt RM, Jin L, Mattheos N. Salivary IL-1β and red complex bacteria as predictors of the inflammatory status in sub-peri-implant niches of subjects with peri-implant mucositis. Clin Oral Implants Res 2015; 27:662-7. [PMID: 26456524 DOI: 10.1111/clr.12713] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Salivary biomarkers may enhance diagnostic sensitivity for peri-implant disease assessment. This study aimed to investigate the association of salivary periodontopathogen count and salivary interleukin-1beta (IL-1β) level with the peri-implant crevicular fluid IL-1β response at peri-implant mucositis (PM) sites among subjects with differing periodontal disease susceptibility. MATERIALS AND METHODS Eighty-seven partially edentulous subjects having at least one implant with peri-implant mucositis were included: 40 with history of chronic periodontitis (P) and 47 with no history of periodontitis (NP). Salivary IL-1β, peri-implant crevicular fluid (PICF) IL-1β, and salivary red complex pathogen counts were recorded. Subjects were scored according to a threshold salivary pathogen level of more than 5log (10) counts and assigned a "red complex score." Quartiles of salivary and PICF IL-1β levels were also scored. Area under receiver operating curve (AUC) was computed to predict the highest PICF IL-1β score using salivary biomarker as predictors and age-adjusted logistic regression performed for the significant predictors. RESULTS In the NP group, red complex score (AUC = 0.758 P = 0.010) (odds ratio = 1.377) and salivary IL-1β (AUC = 0.708 P = 0.038) (odds ratio = 2.506) were significant predictors of highest PICF IL-1β quartile score. In the P group, no significant associations were noted. CONCLUSIONS Salivary biomarkers could distinguish the "high" pro-inflammatory responders at PM sites only in subjects without inherent periodontal disease susceptibility. Periodontal susceptibility may impact the immuno-inflammatory response in sub-peri-implant niches of those with peri-implant mucositis.
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Affiliation(s)
- Aneesha Acharya
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China.,Dr D Y Patil Dental College and Hospital, Pimpri, Pune, India
| | - Mei Leng Koh
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
| | - Supriya Kheur
- Dr D Y Patil Dental College and Hospital, Pimpri, Pune, India
| | - Rory M Watt
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
| | - Lijian Jin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
| | - Nikos Mattheos
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR China
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Wang HL, Garaicoa-Pazmino C, Collins A, Ong HS, Chudri R, Giannobile WV. Protein biomarkers and microbial profiles in peri-implantitis. Clin Oral Implants Res 2015; 27:1129-36. [PMID: 26424287 DOI: 10.1111/clr.12708] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The aim of the present investigation was to determine the profile of peri-implant crevicular fluid (PICF) biomarkers combined with microbial profiles from implants with healthy peri-implant tissues and peri-implantitis to assess real-time disease activity. MATERIAL AND METHODS Sixty-eight patients were included in this cross-sectional study. They were divided into two groups: 34 patients with at least one healthy implant (control) and 34 with at least one peri-implantitis affected implant (test). Total DNA content and qPCR analysis for periodontal bacteria obtained from subgingival plaque samples (Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola) and a PICF analysis for IL-1β, VEGF, MMP-8, TIMP-2, and OPG were performed. The individual and combined diagnostic ability of each biomarker for peri-implantitis and target bacterial species were analyzed. RESULTS The mean concentration of IL-1β (44.6 vs. 135.8 pg/ml; P < 0.001), TIMP-2 (5488.3 vs. 9771.8 pg/ml; P = 0.001), VEGF (59.1 vs. 129.0 pg/ml; P = 0.012), and OPG (66.5 vs. 111.7 pg/ml; P = 0.050) was increased in the peri-implantitis patients. The mean expression of MMP-8 (6029.2 vs. 5943.1 pg/ml; P = 0.454) and did not reveal a meaningful difference among groups. Total bacterial DNA of selected microorganisms was associated with a threefold or greater increase in peri-implantitis although no statistical significant difference. The ability to diagnose diseased sites was enhanced by T. denticola combined with IL-1β, VEGF, and TIMP-2 PICF levels. CONCLUSION The present data suggest that the increased levels of the selected PICF-derived biomarkers of periodontal tissue inflammation, matrix degradation/regulation, and alveolar bone turnover/resorption combined with site-specific microbial profiles may be associated with peri-implantitis and could have potential as predictors of peri-implant diseases.
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Affiliation(s)
- Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Carlos Garaicoa-Pazmino
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Amy Collins
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hwen-Sei Ong
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Rini Chudri
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Renvert S, Widén C, Persson GR. Cytokine expression in peri-implant crevicular fluid in relation to bacterial presence. J Clin Periodontol 2015; 42:697-702. [DOI: 10.1111/jcpe.12422] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Stefan Renvert
- Oral Health Sciences; University of Kristianstad; Kristianstad Sweden
- Blekinge Institute of Technology; Karlskrona Sweden
- School of Dental Sciences; Trinity College; Dublin Ireland
| | - Cecilia Widén
- Oral Health Sciences; University of Kristianstad; Kristianstad Sweden
| | - Gösta Rutger Persson
- Oral Health Sciences; University of Kristianstad; Kristianstad Sweden
- Department of Periodontics; University of Washington; Seattle WA USA
- Department of Oral Medicine; University of Washington; Seattle WA USA
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Flichy-Fernández AJ, Ata-Ali J, Alegre-Domingo T, Candel-Martí E, Ata-Ali F, Palacio JR, Peñarrocha-Diago M. The effect of orally administered probiotic Lactobacillus reuteri
-containing tablets in peri-implant mucositis: a double-blind randomized controlled trial. J Periodontal Res 2015; 50:775-85. [DOI: 10.1111/jre.12264] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2015] [Indexed: 01/13/2023]
Affiliation(s)
| | - J. Ata-Ali
- Oral Surgery and Medicine, Oral Surgery and Implantology; Public Dental Health Service; Arnau de Vilanova Hospital; Valencia University Medical and Dental School; Valencia Spain
| | - T. Alegre-Domingo
- Oral Surgery and Implantology; University of Valencia; Valencia Spain
| | - E. Candel-Martí
- Oral Surgery and Implantology; University of Valencia; Valencia Spain
| | - F. Ata-Ali
- Valencia University Medical and Dental School; Valencia Spain
| | - J. R. Palacio
- Biotechnology and Biomedicine Institute; Barcelona Autonomous University; Barcelona Spain
| | - M. Peñarrocha-Diago
- Oral Surgery, Oral Surgery and Implantology; University of Valencia; Valencia Spain
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Ramseier CA, Eick S, Brönnimann C, Buser D, Brägger U, Salvi GE. Host-derived biomarkers at teeth and implants in partially edentulous patients. A 10-year retrospective study. Clin Oral Implants Res 2015; 27:211-7. [DOI: 10.1111/clr.12566] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2015] [Indexed: 01/04/2023]
Affiliation(s)
- Christoph A. Ramseier
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Sigrun Eick
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Claudia Brönnimann
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Giovanni E. Salvi
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
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Faot F, Nascimento GG, Bielemann AM, Campão TD, Leite FRM, Quirynen M. Can peri-implant crevicular fluid assist in the diagnosis of peri-implantitis? A systematic review and meta-analysis. J Periodontol 2015; 86:631-45. [PMID: 25675962 DOI: 10.1902/jop.2015.140603] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND A broader understanding of the immune inflammatory profile of peri-implant diseases could be helpful in the development of host-targeted preventive and therapeutic strategies. The aim of this study is to answer two clinical questions: 1) whether patients with peri-implantitis (PP) present higher prevalence of any specific inflammatory cytokine in peri-implant crevicular fluid (PICF) compared with healthy patients; and 2) whether local inflammation measured in PICF can be used as a predictor for incipient PP. METHODS A systematic review of the literature on the most common cytokines released in PICF in healthy and PP-affected sites was conducted from 1996 up to and including October 2013 using predefined search strategies. Cross-sectional and prospective longitudinal studies were considered. Meta-analyses were done separately for healthy, mucositis (MU), and PP outcomes. RESULTS Interleukin (IL)-1β was the most studied cytokine (n = 12), followed by tumor necrosis factor (TNF)-α (n = 10). Other cytokines were also linked to PP, such as IL-4, IL-6, IL-8, IL-10, IL-12, and IL-17. Statistical differences were revealed when IL-1β release was compared between healthy implant sites and PP (P = 0.001) or MU sites (P = 0.002), respectively; when PP and MU were compared, no statistical differences could be detected (P = 0.80). For TNF-α release, significant differences were found between healthy and PP implants (P = 0.02). CONCLUSIONS PICF containing inflammatory mediators, such as IL-1β and TNF-α, can be used as additional criteria for a more robust diagnosis of peri-implant infection. Additionally, once the inflammatory process is installed, no differences were found between peri-implant MU and PP.
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Affiliation(s)
- Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Yaghobee S, Khorsand A, Rasouli Ghohroudi AA, Sanjari K, Kadkhodazadeh M. Assessment of interleukin-1beta and interleukin-6 in the crevicular fluid around healthy implants, implants with peri-implantitis, and healthy teeth: a cross-sectional study. J Korean Assoc Oral Maxillofac Surg 2014; 40:220-4. [PMID: 25368834 PMCID: PMC4217267 DOI: 10.5125/jkaoms.2014.40.5.220] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 08/08/2014] [Accepted: 08/27/2014] [Indexed: 11/08/2022] Open
Abstract
Objectives This study aimed to assess and compare the levels of interleukin-1beta (IL-1β) and interleukin-6 (IL-6) in the crevicular fluid around healthy implants, implants with peri-implantitis, and healthy teeth. Materials and Methods This study evaluated 16 dental implants in 8 patients (4 males and 4 females). These patients had at least one healthy implant and one implant with peri-implantitis next to healthy teeth. The crevicular fluid was collected using absorbent cones and transferred to the laboratory. Specimens were evaluated by ELISA for interleukin levels. Data were analyzed using repeated measures ANOVA and Bonferroni tests (P<0.05). Results Levels of IL-1β in the crevicular fluid around implants with peri-implantitis were significantly higher than around healthy implants (P=0.002); the latter was significantly higher than around healthy teeth (P=0.015). A significant difference was found in the level of IL-6 in the crevicular fluid around implants with peri-implantitis and healthy implants (P=0.049) and also between implants with peri-implantitis and healthy teeth (P<0.001). Conclusion Within the limitations of this study, significant differences exist in the levels of IL-1β and IL-6 in the crevicular fluid of implants with peri-implantitis, healthy implants, and healthy teeth. More studies with larger sample sizes in different populations are necessary.
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Affiliation(s)
- Siamak Yaghobee
- Department of Periodontics, Tehran University of Medical Sciences, Tehran, Iran. ; Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Khorsand
- Department of Periodontics, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Mahdi Kadkhodazadeh
- Department of Periodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kadkhodazadeh M, Baghani Z, Ebadian AR, Kaghazchi Z, Amid R. Receptor activator of nuclear factor kappa-B gene polymorphisms in Iranian periodontitis and peri-implantitis patients. J Periodontal Implant Sci 2014; 44:141-6. [PMID: 24921058 PMCID: PMC4050231 DOI: 10.5051/jpis.2014.44.3.141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/31/2014] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Peri-implantitis and periodontitis are inflammatory and infectious diseases of implant and tooth-supporting tissues. Recently, the role of gene polymorphisms of immune response components in the relevant pathogenesis has been investigated. The present study was the first to evaluate the relationship between two known single nucleotide polymorphisms (SNPs) of the receptor activator of nuclear factor kappa-β (RANK) gene (rs3018362 and rs35211496) in chronic periodontitis and peri-implantitis patients in an Iranian population. METHODS Eighty-one periodontally healthy patients, 38 patients with peri-implantitis, and 74 patients with chronic periodontitis were enrolled in this study. DNA was extracted from blood arm vein samples by using Miller's salting out technique according to the manufacturer's instructions given in the extraction kit. The concentration of DNA samples was measured using a spectrophotometer. The genetic polymorphisms of the RANK gene were evaluated using a competitive allele specific polymerase chain reaction (KBioscience allele specific PCR) technique. Differences in the frequencies of genotypes and alleles in the diseased and healthy groups were analyzed using chi-squared statistical tests (P<0.05). RESULTS Analysis of rs35211496 revealed statistically significant differences in the expression of the TT, TC, and CC genotypes among the three groups (P=0.00). No statistically significant difference was detected in this respect between the control group and the chronic periodontitis group. The expression of the GG, GA, and AA genotypes and allele frequencies (rs3018362) showed no statistically significant difference among the three groups (P=0.21). CONCLUSIONS The results of this study indicate that the CC genotype of the rs35211496 RANK gene polymorphism was significantly associated with peri-implantitis and may be considered a genetic determinant for peri-implantitis, but this needs to be confirmed by further studies in other populations.
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Affiliation(s)
- Mahdi Kadkhodazadeh
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Baghani
- Department of Periodontics, School of Dentistry, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Kaghazchi
- Department of Periodontics, School of Dentistry, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dolanmaz D, Saglam M, Inan O, Dundar N, Alniacık G, Gursoy Trak B, Kocak E, Hakki SS. Monitoring bone morphogenetic protein-2 and -7, soluble receptor activator of nuclear factor-κB ligand and osteoprotegerin levels in the peri-implant sulcular fluid during the osseointegration of hydrophilic-modified sandblasted acid-etched and sandblasted acid-etched surface dental implants. J Periodontal Res 2014; 50:62-73. [PMID: 24697526 DOI: 10.1111/jre.12182] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND OBJECTIVE The implant surface plays a major role in the biological response to titanium dental implants. The aim of this study was to investigate levels of soluble receptor activator of nuclear factor-κB ligand (sRANKL), osteoprotegerin (OPG), bone morphogenetic protein-2 (BMP-2) and -7 (BMP-7) in the peri-implant crevicular fluid (PICF) of different implants during the osseointegration period. MATERIAL AND METHODS Forty-seven patients (22 females and 25 males, mean age 47.34 ± 10.11) were included in this study. Forty-seven implants from two implant systems (group A1 (sandblasted acid-etched [SLA]-16), group A2 (hydrophilic-modified SLA [SLActive]-16), and group B (sandblasted acid-etched [SLA]-15) were placed using standard surgical protocols. PICF samples, plaque index, gingival index and probing depth measurements were obtained at 1 and 3 mo after surgery. PICF levels of sRANKL, OPG, BMP-2/-7 were analyzed by ELISA. RESULTS No complications were observed during the healing period. No significant differences were observed in the PICF levels of sRANKL, OPG, BMP-2 and BMP-7 for all groups at any time point (p > 0.05). A significant decrease was observed in BMP-2 levels in group A1 (p < 0.05). A significant increase in BMP-7 levels was observed only for group A2 (p < 0.05). There was a strong negative correlation between OPG and gingival index and a negative correlation between BMP-7 and plaque index (p < 0.05). CONCLUSION Considering the correlations between clinical and biochemical parameters, the levels of these cytokines in PICF during early healing of implants reflects the degree of peri-implant inflammation, rather than differences in the implant surfaces.
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Affiliation(s)
- D Dolanmaz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Selçuk University, Konya, Turkey
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Belibasakis GN. Microbiological and immuno-pathological aspects of peri-implant diseases. Arch Oral Biol 2013; 59:66-72. [PMID: 24209597 DOI: 10.1016/j.archoralbio.2013.09.013] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 09/23/2013] [Accepted: 09/30/2013] [Indexed: 12/11/2022]
Abstract
Peri-implant diseases are a cluster of "contemporary" oral infections in humans that have emerged as a result of the routine application of osseointegrated dental implants in clinical practice. They are characterized by the inflammatory destruction of the implant-supporting tissues, as a result of biofilm formation on the implant surface. Peri-implant mucositis and peri-implantitis are analogous to gingivitis and periodontitis that affect natural teeth. The aim of this comprehensive review was to provide insights into the infectious aetiology and immuno-pathology of peri-implant diseases, and to identify similarities and differences with periodontal diseases. The microbial composition of peri-implantitis-associated biofilms is mixed, non-specific and very similar to that of periodontitis. A considerable exception is the frequent presence of high numbers of staphylococci and enteric bacteria in peri-implantitis. The sequence of immuno-pathological events and the qualitative composition of the immune cells in peri-implant infections are similar to that of periodontal infections. The lesions are characterized predominantly by neutrophils, macrophages, T- and B-cells. Nevertheless, compared to periodontitis, peri-implantitis is marked by a more extensive inflammatory infiltrate and innate immune response, a greater severity of tissue destruction and a faster progression rate. This could well account for the structural differences between the two tissue types, predominantly the lack of periodontal ligament and Sharpey's fibres around implants. In order to support the early diagnosis and prevention of peri-implantitis, it is crucial to explain its fast progression rate by elucidating the underlying molecular mechanisms. This could be achieved, for instance, by utilizing the non-invasive collection and analysis of peri-implant crevicular fluid.
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Affiliation(s)
- Georgios N Belibasakis
- Oral Microbiology and Immunology, Institute of Oral Biology, Center of Dental Medicine, University of Zürich, Plattenstrasse 11, 8032 Zürich, Switzerland.
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Ertugrul AS, Tekin Y, Alpaslan NZ, Bozoglan A, Sahin H, Dikilitas A. Comparison of peri-implant crevicular fluid levels of adrenomedullin and human beta defensins 1 and 2 from mandibular implants with different implant stability quotient levels in nonsmoker patients. J Periodontal Res 2013; 49:480-8. [PMID: 23898869 DOI: 10.1111/jre.12127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE To achieve satisfactory osseointegration, primary stability and healthy peri-implant tissue must be available. In this study, our objective was to compare the adrenomedullin, human beta-defensin (hBD)-1 and hBD-2 levels in implants with different implant stability quotient (ISQ) values and with different peri-implant tissue health values in the peri-implant crevicular fluid. MATERIAL AND METHODS Thirty patients with 60 endosseous osseointegrated implants were included in this study. Following the completion of the osseointegration process, these implants were divided into two main groups: a group of 15 implants with peri-implantitis (peri-implantitis: 40 ≤ ISQ ≤ 80 peri-implantitis, n = 15) and a group of 45 implants with healthy peri-implant tissue. The healthy peri-implant tissue group was further divided into three subgroups according to their ISQ values (Healthy-60: 60 ≤ ISQ ≤ 70, healthy peri-implant, n = 15; Healthy-80: 71 ≤ ISQ ≤ 80, healthy peri-implant, n = 15; and Healthy-100: 81 ≤ ISQ ≤ 100, healthy peri-implant, n = 15). The levels of adrenomedullin, hBD-1 and hBD-2 in the peri-implant crevicular fluid were assessed using ELISAs. RESULTS When the peri-implant clinical measurements were compared within groups, they were found to be highest in the peri-implantitis group and lowest in the Healthy-100 group. The adrenomedullin, hBD-1 and hBD-2 levels in the peri-implant crevicular fluid of the peri-implantitis group were found to be significantly higher than those in the Healthy-60, Healthy-80 and Healthy-100 groups. When only the healthy peri-implant tissue groups were evaluated, the adrenomedullin, hBD-1 and hBD-2 levels in the peri-implant crevicular fluid of the Healthy-60 group were found to be significantly higher than those in the Healthy-80 and Healthy-100 groups. The lowest adrenomedullin, hBD-1 and hBD-2 levels were observed in the Healthy-100 group. CONCLUSION In cases of peri-implantitis, higher adrenomedullin, hBD-1 and hBD-2 levels were observed. These results indicate the presence of a tissue response to prevent the creation of a pathological environment in the peri-implant tissue. In groups with healthy peri-implant tissues, the ISQ value decreases as the adrenomedullin, hBD-1 and hBD-2 levels increase. This condition is thought to be caused by increased dental plaque accumulation and bone resorption in addition to increased lateral implant movements and colonization of microorganisms in the microcavities between the implant elements.
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Affiliation(s)
- A S Ertugrul
- Department of Periodontology, Faculty of Dentistry, Yuzuncu Yil University, Van, Turkey
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