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Ting M, Suzuki JB. Peri-Implantitis. Dent J (Basel) 2024; 12:251. [PMID: 39195095 DOI: 10.3390/dj12080251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 07/25/2024] [Accepted: 07/30/2024] [Indexed: 08/29/2024] Open
Abstract
Peri-implantitis can affect the longevity of successfully integrated implants. Implant success is dependent on reducing the peri-implantitis risk or successfully managing peri-implantitis. Further understanding of peri-implantitis can be derived from its prevalence, microbial and diagnostic findings, existing therapies, and the effects of systemic health issues and medication. Based on published information: (1) peri-implantitis is higher in patients who have periodontitis or smoke as well as in implants with 5 years of function; (2) peri-implantitis microflora is different from periodontitis; (3) peri-implantitis risk is increased in patients with cardiovascular diseases and uncontrolled diabetes; (4) most reported peri-implantitis therapies may result in resolution, but the best peri-implantitis treatment is still to be determined; (5) more frequent peri-implant maintenance may reduce risk for peri-implantitis.
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Affiliation(s)
- Miriam Ting
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Think Dental Learning Institute, Paoli, PA 19301, USA
| | - Jon B Suzuki
- Department of Graduate Periodontics, University of Maryland, Baltimore, MD 20742, USA
- Department of Graduate Prosthodontics, University of Washington, Seattle, WA 98195, USA
- Department of Graduate Periodontics, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Department of Microbiology and Immunology (Medicine), Temple University, Philadelphia, PA 19140, USA
- Department of Periodontology and Oral Implantology (Dentistry), Temple University, Philadelphia, PA 19140, USA
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Park SE, Park K, Kim E, Kim CY, Hwang SM, Lee JM, Suh JY, Lee Y, Kim MO, Kim YG. CXCL5/CXCL8 induces neutrophilic inflammation in peri-implantitis. J Periodontal Res 2024; 59:698-711. [PMID: 38699841 DOI: 10.1111/jre.13230] [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: 10/10/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 05/05/2024]
Abstract
OBJECTIVE AND BACKGROUND This research aimed to examine the role of C-X-C motif chemokine ligand 5 (CXCL5) and C-X-C motif chemokine ligand 8 (CXCL8; also known as IL-8) in neutrophilic inflammation triggered by peri-implantitis and to shed light on the underlying mechanisms that link them to the development of this condition. MATERIALS This study included 40 patients who visited the Department of Periodontology at Kyungpook University Dental Hospital. They were divided into two groups based on their condition: healthy implant (HI) group (n = 20) and peri-implantitis (PI) group (n = 20). Biopsy samples of PI tissue were collected from the patients under local anesthesia. HI tissue was obtained using the same method during the second implant surgery. To construct libraries for control and test RNAs, the QuantSeq 3' mRNA-Seq Library Prep Kit (Lexogen, Inc., Austria) was used according to the manufacturer's instructions. Samples were pooled based on representative cytokines obtained from RNA sequencing results and subjected to Reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Hematoxylin and eosin staining, and immunohistochemistry (IHC) analysis were performed to visually assess expression levels and analyze tissue histology. Student's t-test was employed to conduct statistical analyses. RESULTS Initially, heatmaps were used to examine gene expression variations between the HI and PI groups based on the results of RNA sequencing. Notably, among various cytokines, CXCL5 and CXCL8 had the highest expression levels in the PI group compared with the HI group, and they are known to be associated with inflammatory responses. In the gingival tissues, the expression of genes encoding cytokines such as interleukin (IL)-1β, tumor necrosis factor-alpha (TNF)-α, interleukin (IL)-6, and CXCL5/CXCL8 was assessed via RT-qPCR. The mRNA expression level of CXCL5/CXCL8 significantly increased in the PI group compared with the HI group (p < .045). Contrarily, the mRNA expression level of interleukin 36 receptor antagonist (IL36RN) significantly decreased (p < .008). IHC enabled examination of the distribution and intensity of CXCL5/CXCL8 protein expression within the tissue samples. Specifically, increased levels of CXCL5/CXCL8 promote inflammatory responses, cellular proliferation, migration, and invasion within the peri-implant tissues. These effects are mediated through the activation of the PI3K/Akt/NF-κB signaling pathway. CONCLUSIONS This study found that the PI sites had higher gene expression level of CXCL8/CXCL5 in the soft tissue than HI sites, which could help achieve more accurate diagnosis and treatment planning.
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Affiliation(s)
- Seong-Eun Park
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Kanghyun Park
- Department of Animal Science and Biotechnology, Research Institute for Innovative Animal Science, Kyungpook National University, Sangju, Korea
| | - Eungyung Kim
- Department of Animal Science and Biotechnology, Research Institute for Innovative Animal Science, Kyungpook National University, Sangju, Korea
| | - Chae Yeon Kim
- Department of Animal Science and Biotechnology, Research Institute for Innovative Animal Science, Kyungpook National University, Sangju, Korea
| | - Sung-Min Hwang
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Jae-Mok Lee
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Jo-Young Suh
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Youngkyun Lee
- Department of Biochemistry and Institute for Hard Tissue and Bone Regeneration, Kyungpook National University School of Dentistry, Daegu, Korea
| | - Myoung Ok Kim
- Department of Animal Science and Biotechnology, Research Institute for Innovative Animal Science, Kyungpook National University, Sangju, Korea
| | - Yong-Gun Kim
- Department of Periodontology, Kyungpook National University School of Dentistry, Daegu, Korea
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Soysal F, Unsal B, Isler SC, Akca G, Bakirarar B, Ozcan M. Evaluation of salivary stress markers and inflammatory cytokine levels in peri-implantitis patients. Clin Oral Investig 2024; 28:290. [PMID: 38691206 PMCID: PMC11062951 DOI: 10.1007/s00784-024-05692-5] [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: 10/11/2023] [Accepted: 04/24/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND AND OBJECTIVE Psychological stress has been identified in some observational studies as a potential factor that may modify and affect periodontal diseases, but there are no similar data for peri-implantitis. The aim of this study was to determine the relationship between interleukin (IL)-1β, IL-6, IL-10, interferon (IFN)α inflammatory cytokines and the psychological stress-related markers, glucocorticoid receptor-α (GRα), and salivary α-amylase (sAA) gene expression levels in saliva samples obtained from healthy implants and peri-implantitis patients. MATERIALS AND METHODS The study included a total of 50 systemically healthy subjects. Peri-implant clinical parameters were recorded and psychological stress level was evaluated with the hospital anxiety and depression scale (HAD) and state-trait anxiety inventory (STAI) questionnaire forms. Following the evaluations, the patients were divided into 4 groups according their stress and clinical status (Ia, Ib, IIa, IIb). IL-1β, IL-6, IL-10, IFNα, GRα, sAA gene expression levels in the saliva samples were quantified by quantitative polymerase chain reaction (qPCR). RESULTS In the group of peri-implantitis who had a high score in stress level assessment scales, significantly higher IL-1β, IL-6, sAA expression levels were observed (p < 0.001). The IL-10 gene expression levels were lower in the groups with a high score in the stress level assessment scales (p < 0.001). GRα gene was expressed at lower levels in the group of peri-implantitis who had a high score in stress level assessment scales but the difference was not statistically significant (p = 0.065). CONCLUSION The study findings suggest that psychological stress may increase the inflammation associated with peri-implantitis by affecting cytokine expression levels. CLINICAL RELEVANCE To prevent peri-implantitis or reduce its prevalence, it could be beneficial to evaluate stress levels and identify individuals experiencing stress.
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Affiliation(s)
- Fatma Soysal
- Department of Periodontology, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey.
| | - Berrin Unsal
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sila Cagri Isler
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gulcin Akca
- Department of Medical Microbiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Batuhan Bakirarar
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mustafa Ozcan
- Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Alarcón-Sánchez MA, Guerrero-Velázquez C, Becerra-Ruiz JS, Rodríguez-Montaño R, Avetisyan A, Heboyan A. IL-23/IL-17 axis levels in gingival crevicular fluid of subjects with periodontal disease: a systematic review. BMC Oral Health 2024; 24:302. [PMID: 38431633 PMCID: PMC10909298 DOI: 10.1186/s12903-024-04077-0] [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: 12/23/2023] [Accepted: 02/26/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The IL-23/IL-17 axis plays an important role in the immunopathogenesis of periodontal disease. A systematic review was conducted to synthesize all research reporting on the levels of the IL-23/IL-17 axis in gingival crevicular fluid (GCF) from subjects with gingivits, and periodontitis, compared to healthy controls. METHODS The protocol followed the PRISMA, and Cochrane guidelines, and was registered with the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/7495V . A search was conducted in the electronic databases PubMed/MEDLINE, Scopus, Google Schoolar, and Cochrane from November 15th, 2005, to May 10th, 2023. The quality of the studies was assessed using the JBI tool for cross-sectional studies. RESULTS The search strategy provided a total of 2,098 articles, of which 12 investigations met the inclusion criteria. The total number of patients studied was 537, of which 337 represented the case group (subjects with gingivitis, and chronic periodontitis), and 200 represented the control group (periodontally healthy subjects). The ages of the patients ranged from 20 to 50 years, with a mean (SD) of 36,6 ± 4,2, of which 47% were men, and 53% were women. 75% of the investigations collected GCF samples with absorbent paper strips, and analyzed cytokine IL-17 levels individually. In addition, qualitative analysis revealed that there are differences between IL-23/IL-17 axis levels in subjects with chronic periodontitis, gingivitis and healthy controls. CONCLUSIONS Thus, IL-23/IL-17 axis levels could be used in the future as a diagnostic tool to distinguish between periodontal diseases.
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Affiliation(s)
- Mario Alberto Alarcón-Sánchez
- Biomedical Science, Faculty of Chemical-Biological Sciences, Autonomous University of Guerrero, Chilpancingo de los Bravo, Guerrero 39090, Mexico
| | - Celia Guerrero-Velázquez
- Research Institute of Dentistry, Department of Integrated Dentistry Clinics, University of Guadalajara (CUCS-UdeG), 950 Sierra Mojada, Guadalajara 44340, Jalisco, Mexico.
| | - Julieta Sarai Becerra-Ruiz
- Institute of Research of Bioscience, University Center of Los Altos, University of Guadalajara, Tepatitlán de Morelos 47600, Jalisco, Mexico
| | - Ruth Rodríguez-Montaño
- Department of Health and Illness as an Individual and Collective Process, University Center of Tlajomulco, University of Guadalajara (CUTLAJO-UdeG), Tlajomulco, Santa Fé Highway Km 3.5 No. 595, Lomas de Tejeda, Tlajomulco de Zuñiga 45641, Jalisco, Mexico
| | - Anna Avetisyan
- Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan, 0025, Armenia
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600 077, India.
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan, 0025, Armenia.
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, North Karegar St, Tehran, Iran.
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Fornasaro S, Rapani A, Farina F, Ibishi M, Pisnoli G, Stacchi C, Sergo V, Bonifacio A, Di Lenarda R, Berton F. Spectroscopic insights into peri-implant mucositis and peri-implantitis: unveiling peri-implant crevicular fluid profiles using surface enhanced Raman scattering. Analyst 2024; 149:885-894. [PMID: 38179644 DOI: 10.1039/d3an01438j] [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: 01/06/2024]
Abstract
The precise identification and differentiation of peri-implant diseases, without the need for intrusive procedures, is crucial for the successful clinical treatment and overall durability of dental implants. This work introduces a novel approach that combines surface-enhanced Raman scattering (SERS) spectroscopy with advanced chemometrics to analyse peri-implant crevicular fluid (PICF) samples. The primary purpose is to offer an unbiased evaluation of implant health. A detailed investigation was performed on PICF samples obtained from a cohort of patients exhibiting different levels of peri-implant health, including those with healthy implants, implants impacted by peri-implantitis, and implants with peri-implant mucositis. The obtained SERS spectra were analysed using canonical-powered partial least squares (CPPLS) to identify unique chemical characteristics associated with each inflammatory state. Significantly, our research findings unveil the presence of a common inflammatory SERS spectral pattern in cases of peri-implantitis and peri-implant mucositis. Furthermore, the SERS-based scores obtained from CPPLS were combined with established clinical scores and subjected to a linear discriminant analysis (LDA) classifier. Repeated double cross-validation was used to validate the method's capacity to discriminate different implant conditions. The integrated approach showcased high sensitivity and specificity and an overall balanced accuracy of 92%, demonstrating its potential to serve as a non-invasive diagnostic tool for real-time implant monitoring and early detection of inflammatory conditions.
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Affiliation(s)
- Stefano Fornasaro
- University of Trieste, Department of Chemical and Pharmaceutical Sciences, via L. Giorgeri 1, 34127 Trieste, Italy.
| | - Antonio Rapani
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34125, Trieste, Italy
| | - Federica Farina
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34125, Trieste, Italy
| | - Marigona Ibishi
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34125, Trieste, Italy
| | - Giulia Pisnoli
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34125, Trieste, Italy
| | - Claudio Stacchi
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34125, Trieste, Italy
| | - Valter Sergo
- Raman Spectroscopy Lab, Department of Engineering and Architecture, University of Trieste, via A. Valerio 6a, 34127 Trieste, Italy
| | - Alois Bonifacio
- Raman Spectroscopy Lab, Department of Engineering and Architecture, University of Trieste, via A. Valerio 6a, 34127 Trieste, Italy
| | - Roberto Di Lenarda
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34125, Trieste, Italy
| | - Federico Berton
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34125, Trieste, Italy
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Roemermann DL, Atout R, Pesun I, Kelekis-Cholakis A, Stavropoulou C, Renvert SN, França R. An In Vivo Investigation of Non-Metallic vs. Metallic Hand Scalers on Zirconia Implant-Supported Crowns: A Year-Long Analysis of Peri-Implant Maintenance. J Funct Biomater 2023; 15:9. [PMID: 38248676 PMCID: PMC10817302 DOI: 10.3390/jfb15010009] [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: 11/24/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
This study examined whether the degree of abutment surface modification that may occur with regular periodontal instrumentation has a clinical impact in terms of increased plaque accumulation and increased peri-implant tissue inflammation on zirconia implant abutments. Thirteen patients who had zirconia implant crowns were recruited in this randomized clinical trial. Each patient acted as their control and had either the buccal or lingual surface of their screw-retained implant restoration scaled with a metallic scaler and the other surface with a non-metallic scaler at 3, 6, 9, and 12 months. Cytokine testing of the peri-implant crevicular fluid was completed at 0, 3, and 12 months for IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, or IFNγ. Implant crowns were removed at 12 months and evaluated under an atomic force microscope for the average roughness (Ra). The implant crowns were polished and re-inserted. The results were analyzed using the Kruskal-Wallis test, and post hoc tests were conducted with a significance level of α = 0.05. Significant differences in surface roughness (Ra) were observed between the metallic and non-metallic scalers. The median Ra values were 274.0 nm for metallic scalers and 147.1 nm for non-metallic scalers. However, there were no significant differences between the type of scaler used and the amount of clinical inflammation or cytokine production. Metallic scalers produced deeper, more aggressive surface alterations to the abutment/crown zirconia surface, but there was no statistically significant difference between the degree of surface alterations, amount of BOP, and the amplitude of cytokine inflammation produced.
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Affiliation(s)
- Dayna L. Roemermann
- Department of Dental Diagnostic and Surgical Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (D.L.R.); (R.A.); (A.K.-C.); (C.S.)
| | - Reem Atout
- Department of Dental Diagnostic and Surgical Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (D.L.R.); (R.A.); (A.K.-C.); (C.S.)
| | - Igor Pesun
- Department of Restorative Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
| | - Anastasia Kelekis-Cholakis
- Department of Dental Diagnostic and Surgical Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (D.L.R.); (R.A.); (A.K.-C.); (C.S.)
| | - Chrysi Stavropoulou
- Department of Dental Diagnostic and Surgical Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (D.L.R.); (R.A.); (A.K.-C.); (C.S.)
| | - Stefan N. Renvert
- Oral Health Sciences, Kristianstad University, 291 88 Kristianstad, Sweden;
| | - Rodrigo França
- Department of Restorative Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
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Noguchi T, Morita S, Suzuki R, Matsunaga S, Hirouchi H, Kasahara N, Sugahara K, Abe S. Structural analysis of the mylohyoid muscle as a septum dividing the floor of the oral cavity for the purposes of dental implant surgery: variety of muscle attachment positions and ranges of distribution. Int J Implant Dent 2023; 9:49. [PMID: 38066306 PMCID: PMC10709272 DOI: 10.1186/s40729-023-00513-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/05/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES The objective was to investigate the details of the attachments of the mylohyoid muscle to the mandible anterior to the hyoid and mylohyoid lines to understand the positional relationship between the sublingual space and the mylohyoid, knowledge that is essential for dental implant surgery in the incisal region, as well as the routes of communication between the sublingual space and other spaces. METHODS While evaluating the presence or absence of an anterior mylohyoid muscle fiber attachment to the mandible, sublingual gland herniation, spaces between muscle fascicles were also recorded as sites of penetration. The mean muscle thickness in each of these areas was also calculated. RESULTS In all specimens, the mylohyoid originated not only from the mylohyoid line but also from the lingual surface of the center of the mandibular body (the mandibular symphysis) below the mental spines. The mylohyoid muscle fascicles were thickest in the posterior region, and further anterior to this, they tended to become thinner. Sublingual gland herniations passing through the mylohyoid were noted in the anterior and central regions, but not in the posterior region. Penetration between the muscle fascicles was most common in the central region, and no such penetration was evident in the posterior region. CONCLUSIONS These results suggest that the mylohyoid functions only incompletely as a septum, and that routes of communication from the sublingual space to the submandibular space may be present in both the anterior and central muscle fascicles of the mylohyoid. Therefore, bleeding complications during dental implant placement in the anterior mandible can be serious issues. There is a potential for sublingual hematoma that could compromise the airway by pressing the tongue against the soft palate into the pharynx.
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Affiliation(s)
- Taku Noguchi
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Sumiharu Morita
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Ryu Suzuki
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Satoru Matsunaga
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan.
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan.
| | - Hidetomo Hirouchi
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Norio Kasahara
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
- Department of Histology & Developmental Biology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Keisuke Sugahara
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
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Yan Y, Orlandi M, Suvan J, Harden S, Smith J, D’Aiuto F. Association between peri-implantitis and systemic inflammation: a systematic review. Front Immunol 2023; 14:1235155. [PMID: 37691939 PMCID: PMC10484704 DOI: 10.3389/fimmu.2023.1235155] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/02/2023] [Indexed: 09/12/2023] Open
Abstract
Background Peri-implantitis is an infectious/inflammatory disease with similar clinical and radiographic features to periodontitis. Overwhelming evidence confirmed that periodontitis causes elevations in systemic inflammatory mediators; this is unclear for peri-implantitis. Hence, this study aimed to appraise all available evidence linking peri-implantitis with systemic inflammation. Methods A systematic review was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Web of Science, Dentistry & Oral Sciences Source, Scopus, LILACS, and China Online), ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP), and gray literature were searched up to February 9, 2023. Human studies of randomized controlled trials, non-randomized intervention studies, cohort studies, case-control, and cross-sectional studies were eligible for inclusion. Quantitative analyses were performed using random effects models. Results A total of 27 full-text articles were retrieved, and 11 clinical studies were included in the final analyses. All evidence gathered demonstrated a consistent association between peri-implantitis and systemic inflammation. Patients with peri-implantitis exhibited higher levels of serum C-reactive protein (CRP) (standard mean difference (SMD): 4.68, 98.7% CI: 2.12 to 7.25), interleukin-6 (IL-6) (weighted mean difference (WMD): 6.27 pg/mL, 0% CI: 5.01 to 7.54), and white blood cell counts (WMD: 1.16 * 103/μL, 0% CI: 0.61 to 1.70) when compared to participants without peri-implantitis. Conclusion Peri-implantitis is associated with higher systemic inflammation as assessed by serum CRP, IL-6, and white blood cell counts. Further research is needed to clarify the nature of this association. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=246837, identifier CRD42021246837.
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Affiliation(s)
- Yumeng Yan
- Periodontology Unit, University College London (UCL) Eastman Dental Institute, University College London (UCL), London, United Kingdom
| | - Marco Orlandi
- Periodontology Unit, University College London (UCL) Eastman Dental Institute, University College London (UCL), London, United Kingdom
| | - Jeanie Suvan
- Periodontology Unit, University College London (UCL) Eastman Dental Institute, University College London (UCL), London, United Kingdom
| | - Simon Harden
- Department of Statistical Science, University College London (UCL) Eastman Dental Institute, University College London (UCL), London, United Kingdom
| | - Jacqueline Smith
- Library Services, University College London (UCL), London, United Kingdom
| | - Francesco D’Aiuto
- Periodontology Unit, University College London (UCL) Eastman Dental Institute, University College London (UCL), London, United Kingdom
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Halstenbach T, Nelson K, Iglhaut G, Schilling O, Fretwurst T. Impact of peri-implantitis on the proteome biology of crevicular fluid: A pilot study. J Periodontol 2023; 94:835-847. [PMID: 36585920 DOI: 10.1002/jper.22-0461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/22/2022] [Accepted: 12/15/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The proteome of the peri-implant crevicular fluid (PICF) has not been systematically investigated. The aim of the present study was to reveal the proteome biology of dental implants affected with peri-implantitis. METHODS Patients with at least one diseased implant were included (probing depth ≥6 mm, ≥3 mm peri-implant radiological bone loss). Using sterile paper strips, samples were collected from healthy implants (I), healthy teeth (T) and peri-implantitis affected implants (P). Proteome analysis was performed using liquid chromatography - tandem mass spectrometry (LC-MS/MS) and data independent acquisition, allowing the identification and quantification of human and bacterial proteins as well as semi-specific peptides. RESULTS A total of 38 samples from 14 patients were included in the study; 2332 different human proteins were identified across all samples. No differentially expressed proteins between T and I were found. Comparing P to I, 59 proteins were found upregulated and 31 downregulated in P with significance. Upregulated proteins included proinflammatory proteins such as immunoglobulins, dysferlin, and S100P, as well as antimicrobial proteins, for example, myeloperoxidase or azurocidin. Gene ontology analysis further revealed higher activity of immunological pathways. Proteolytic patterns indicated the activity of inflammatory proteins such as cathepsin G. A total of 334 bacterial proteins were identified and quantified. Peri-implantitis showed elevated proteolytic activity. CONCLUSION I and T share similarities in their proteome, while diseased implants deviate strongly from healthy conditions. The PICF proteome of peri-implantitis affected sites exhibits an inflammatory fingerprint, dominated by neutrophil activity when compared with healthy implants.
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Affiliation(s)
- Tim Halstenbach
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Division of Regenerative Oral Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
- Institute of Surgical Pathology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Katja Nelson
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Division of Regenerative Oral Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Gerhard Iglhaut
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Division of Regenerative Oral Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Oliver Schilling
- Institute of Surgical Pathology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Tobias Fretwurst
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Division of Regenerative Oral Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
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10
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Chmielewski M, Pilloni A. Current Molecular, Cellular and Genetic Aspects of Peri-Implantitis Disease: A Narrative Review. Dent J (Basel) 2023; 11:dj11050134. [PMID: 37232785 DOI: 10.3390/dj11050134] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
(1) Background: Peri-implantitis is a multi-factorial disease with an inflammatory background that occurs in both soft and hard tissues surrounding implants. In recent years, the understanding of the cellular, molecular and genetic background of peri-implantitis has broadened. This study aims to summarize the currently available articles on the subject and highlight the most recent advances over the last 20 years. (2) Methods: For this study, the Embase and PubMed libraries were searched using the keywords: ("peri-implantitis" AND "cytokine" OR "genetics" OR "cellular") and ("peri-implantitis" AND "cytokine" OR "genetics" OR "cellular" AND "risk factors"). The search revealed a total of 3013 articles (992 from PubMed, 2021 from Embase). Following screening of the titles and abstracts and full-text reads, 55 articles were included. (3) Results: In peri-implantitis IL-6, IL-1β, TNF-α, MMP-8 and their genetic variations appear to be the most important cytokines in relation to not only pathogenesis, but also their potential diagnostic capabilities. Epithelial and inflammatory cells, along with those of the bone lineage, are prime cellular elements found in peri-implantitis. (4) Conclusions: A wide array of cells stand behind peri-implantitis, as well as cytokines and their genetic variations that take part in the process. However, the growing interest in this topic has led to the introduction of specific new diagnostic tools to enable a better understanding of patients' responses to treatment and, in turn, to even enable prediction of the risk of developing peri-implant disease.
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Affiliation(s)
| | - Andrea Pilloni
- Section of Periodontics, Department of Oral and Maxillo-Facial Sciences, Sapienza Unviersity of Rome, 00185 Rome, Italy
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11
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Djinic Krasavcevic A, Nikolic N, Milinkovic I, Carkic J, Jezdic M, Jankovic S, Aleksic Z, Milasin J. Notch signalling cascade and proinflammatory mediators in peri-implant lesions with different RANKL/OPG ratios-An observational study. J Periodontal Res 2023; 58:360-368. [PMID: 36617525 DOI: 10.1111/jre.13096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/24/2022] [Accepted: 12/29/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND & OBJECTIVE Notch signaling pathway has been linked to bone loss in periodontitis and peri-implantitis. This research aimed to determine the Notch signaling molecules expression levels (Notch1, Notch2, Jagged1, Hes1, and Hey1), along with bone remodeling mediators (RANKL and OPG) and proinflammatory cytokines (TNF-α, IL-17, IL-1β, and IL-6) in patients with peri-implant diseases. The aforementioned markers' expression was evaluated in patients with different RANKL/OPG ratios. METHODS Fifty patients with peri-implantitis (PI group) and 45 patients with peri-implant mucositis (PM group) were enrolled. Relative gene expression levels of investigated molecules were determined by reverse transcriptase-real-time polymerase chain reaction. On the basis of RANKL/OPG ratio, all peri-implant lesions were divided into subgroups: RANKL-predominant (RANKL > OPG) and OPG-predominant (RANKL < OPG). Clinical periodontal parameters (probing depth-PD, bleeding on probing-BOP, clinical attachment level-CAL and plaque index-PLI), were recorded for each patient around every tooth, and around placed implants (PDi, BOPi, CALi, PLIi). RESULTS RANKL-predominant PM patients exhibited higher expression levels of Notch2 (p = .044) and Hey1 (p = .005) compared to OPG-predominant lesions. In all RANKL-predominant cases, Hey1 (p = .001), IL-1β (p = .005), IL-6 (p = .002) were overexpressed in PI comparing to PM, accompanied with significantly higher PDi, CALi and PLIi in PI than PM (p = .001, p = .001 and p = .009). CONCLUSIONS Notch2 upregulation in RANKL-predominant PM lesions could be an important contributor to alveolar bone resorption and represent a predictor of PM to PI transition. Similarly, the overexpression of IL-1β and IL-6 might provide an osteoclastogenic environment in PI RANKL-predominant lesions.
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Affiliation(s)
- Ana Djinic Krasavcevic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Nadja Nikolic
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Iva Milinkovic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Carkic
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Jezdic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Sasha Jankovic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Aleksic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Milasin
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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12
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Bornes R, Montero J, Correia A, Marques T, Rosa N. Peri-implant diseases diagnosis, prognosis and dental implant monitoring: a narrative review of novel strategies and clinical impact. BMC Oral Health 2023; 23:183. [PMID: 36997949 PMCID: PMC10061972 DOI: 10.1186/s12903-023-02896-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND The diagnosis of peri-implantar and periodontal relies mainly on a set of clinical measures and the evaluation of radiographic images. However, these clinical settings alone are not sufficient to determine, much less predict, periimplant bone loss or future implant failure. Early diagnosis of periimplant diseases and its rate of progress may be possible through biomarkers assessment. Once identified, biomarkers of peri-implant and periodontal tissue destruction may alert the clinicians before clinical signs show up. Therefore, it is important to consider developing chair-side diagnostic tests with specificity for a particular biomarker, indicating the current activity of the disease. METHODS A search strategy was created at Pubmed and Web of Science to answer the question: "How the molecular point-of-care tests currently available can help in the early detection of peri-implant diseases and throws light on improvements in point of care diagnostics devices?" RESULTS The PerioSafe® PRO DRS (dentognostics GmbH, Jena) and ImplantSafe® DR (dentognostics GmbH, Jena ORALyzer® test kits, already used clinically, can be a helpful adjunct tool in enhancing the diagnosis and prognosis of periodontal/peri-implantar diseases. With the advances of sensor technology, the biosensors can perform daily monitoring of dental implants or periodontal diseases, making contributions to personal healthcare and improve the current status quo of health management and human health. CONCLUSIONS Based on the findings, more emphasis is given to the role of biomarkers in diagnosing and monitoring periodontal and peri-implant diseases. By combining these strategies with traditional protocols, professionals could increase the accuracy of early detection of peri-implant and periodontal diseases, predicting disease progression, and monitoring of treatment outcomes.
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Affiliation(s)
- Rita Bornes
- Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal.
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - André Correia
- Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal
| | - Tiago Marques
- Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal
| | - Nuno Rosa
- Faculty of Dental Medicine (FMD), Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal
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Delucchi F, Canepa C, Canullo L, Pesce P, Isola G, Menini M. Biomarkers from Peri-Implant Crevicular Fluid (PICF) as Predictors of Peri-Implant Bone Loss: A Systematic Review. Int J Mol Sci 2023; 24:ijms24043202. [PMID: 36834613 PMCID: PMC9966862 DOI: 10.3390/ijms24043202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
The aim of the present systematic review is to summarize current knowledge regarding the analysis of biomarkers extracted from peri-implant crevicular fluid (PICF) as predictors of peri-implant bone loss (BL). An electronic search was conducted on three databases, PubMed/MEDLINE, Cochrane Library, and Google Scholar, to find clinical trials published until 1 December 2022 suitable to answer the following focused question: in patients with dental implants, are biomarkers harvested from PICF predictive of peri-implant BL? The initial search yielded a total of 158 entries. After a full-text review and application of the eligibility criteria, the final selection consisted of nine articles. The risk of bias in included studies was assessed using the Joanna Briggs Institute Critical Appraisal tools (JBI). According to the present systematic review, some inflammatory biomarkers harvested from PICF (collagenase-2, collagenase-3, ALP, EA, gelatinase b, NTx, procalcitonin, IL-1β, and several miRNAs) seem to be correlated with peri-implant BL and may assist in the early diagnosis of pathological BL, that characterizes peri-implantitis. MiRNA expression demonstrated a predictive potential of peri-implant BL that could be useful for host-targeted preventive and therapeutic purposes. PICF sampling may represent a promising, noninvasive, and repeatable form of liquid biopsy in implant dentistry.
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Affiliation(s)
- Francesca Delucchi
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Largo R. Benzi 10, 16132 Genova, Italy
| | - Camilla Canepa
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Largo R. Benzi 10, 16132 Genova, Italy
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Largo R. Benzi 10, 16132 Genova, Italy
- Correspondence:
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Largo R. Benzi 10, 16132 Genova, Italy
| | - Gaetano Isola
- Unit of Periodontology, Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Catania, Italy
| | - Maria Menini
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, Largo R. Benzi 10, 16132 Genova, Italy
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14
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Ozgur E, Topcu DI, Bayraktar N, Alptekin NO. Peri-implant crevicular fluid and serum levels of soluble ST2 in peri-implant diseases: A pilot study. J Periodontal Res 2023; 58:204-211. [PMID: 36504319 DOI: 10.1111/jre.13082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/30/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Soluble ST2 (sST2) is a current biomarker of cardiovascular disease. It is used to predict susceptibility to cardiovascular diseases and to analyze their prognosis. Serum sST2 level increases in inflammatory diseases such as periodontitis. However, the level of sST2 in peri-implant diseases and crevicular fluid has not been investigated yet. Thus, the aim of this cross-sectional study is to analyze the level of sST2 in peri-implant health and diseases. METHODS Sixty-nine participants were divided into 3 groups as peri-implant health (PH), peri-implant mucositis (PM), and peri-implantitis (P-I). Peri-implant crevicular fluid (PICF) and serum samples were collected from each participant. The levels of sST2 and IL-6 in PICF and sST2, IL-6, and CRP in serum were compared between the groups. Pocket depth (PD), modified bleeding index (mBI), modified plaque index (mPI), keratinized mucosa index (KTW), and gingival/mucosal recession (REC) were recorded as clinical parameters. Biomarkers in the serum and PICF were analyzed by ELISA kit. RESULTS Sixty-nine patients were included in the study. The differences in the following parameters were statistically significant between groups: age (p = .009), implant function time (p = .027), PD (p < .001), mBI (p < .001), mPI (p < .001), and KTW (p = .043). The PICF volume of P-I and PM groups were statistically higher than PH (p < .001). The amount of sST2 in P-I and PM groups were higher than PH (p = .043). Serum CRP was higher in the P-I group than in other groups (p = .034). There were no significant differences in serum sST2 (p = .247) and IL-6 (p = .110) levels between groups. CONCLUSION The PICF levels of sST2 were significantly higher in PM and P-I groups compared to the healthy group. However, no significant difference was observed between the groups in terms of serum sST2 level.
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Affiliation(s)
- Engin Ozgur
- Department of Periodontology, Faculty of Dentistry, Başkent University, Ankara, Turkey
| | - Deniz Ilhan Topcu
- Department of Medical Biochemistry, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Nilufer Bayraktar
- Department of Medical Biochemistry, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Nilgun Ozlem Alptekin
- Department of Periodontology, Faculty of Dentistry, Başkent University, Ankara, Turkey
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15
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Anitua E, Alkhraisat MH, Eguia A. On Peri-Implant Bone Loss Theories: Trying To Piece Together the Jigsaw. Cureus 2023; 15:e33237. [PMID: 36733558 PMCID: PMC9890078 DOI: 10.7759/cureus.33237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
This review aims to explore the plausibility of new theories on the etiopathogenesis of marginal bone loss (MBL) and peri-implantitis (PI) and to discuss possible underlying pathogenic mechanisms. The former concept of osteointegration of dental implants can now be conceptualized as a foreign body response histologically characterized by a bony demarcation in combination with chronic inflammation. Different risk factors can provoke additional inflammation and, therefore, pro-inflammatory cytokine release in soft tissues and bone, leading to an overpass of the threshold of peri-implant bone defensive and regenerative capacity. Progressive bone loss observed in MBL and PI is ultimately due to a localized imbalance in the receptor activator of nuclear factor kappaB ligand (RANKL)/Receptor activator of nuclear factor κ B (RANK)/osteoprotegerin (OPG) pathway in favor of increased catabolic activity. The genetic background and the severity and duration of the risk factors could explain differences between individuals in the threshold needed to reach an imbalanced scenario. MBL and PI pathogenesis could be better explained by the "inflammation-immunological balance" theory rather than a solely "infectious disease" conception. The link between the effect of biofilm and other risk factors leading to an imbalanced foreign body response lies in osteoclast differentiation and activation pathways (over)stimulation.
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Affiliation(s)
- Eduardo Anitua
- Regenerative Medicine Laboratory, Instituto Eduardo Anitua, Vitoria, ESP
| | | | - Asier Eguia
- Estomatology II, University of The Basque Country (Universidad del País Vasco, UPV/Euskal Herriko Unibertsitatea, EHU), Leioa, ESP
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16
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Djuran B, Tatic Z, Perunovic N, Pejcic N, Vukovic J, Petkovic-Curcin A, Vojvodic D, Rakic M. Underdiagnosis in Background of Emerging Public Health Challenges Related to Peri-Implant Diseases: An Interventional Split-Mouth Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010477. [PMID: 36612810 PMCID: PMC9819861 DOI: 10.3390/ijerph20010477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 06/02/2023]
Abstract
Peri-implant diseases are an emerging public health problem, and it's considered that limitations of standard diagnostics play the role herein. The study objective was the estimation of pathological bone resorption at clinical and biological level in patients with peri-implant mucositis (PIM) and peri-implantitis (PI) before and 6 months after standard treatment and to compare them with healthy controls (HC). The split-mouth interventional study included 60 patients affected with PIM or PI. Patients that also presented at least one more HC were enrolled in the study and underwent standard non-surgical and surgical treatment, respectively. Standard clinical parameters and soluble levels of RANKL were measured in peri-implant crevicular fluid baseline and 6 months following treatment. Clinical parameters and RANKL significantly decreased following treatment in PIM and PI. However, bleeding on probing and probing depth remained significantly increased when compared to HC. RANKL answered requests for biomarker of peri-implant diseases, its baseline levels were significantly increased in PIM and PI, they decreased following treatment and reached HC in peri-implantitis, while in PIM RANKL remained significantly increased. Presence of pathological bone resorption in patients lacked its clinical signs, and respective persistence following treatment suggest the need for biomarker-supported diagnosis for timely diagnosis of peri-implantitis and appropriate orientation of respective management strategies.
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Affiliation(s)
- Boris Djuran
- Department of Oral Implantology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Zoran Tatic
- Department of Oral Implantology, Military Medical Academy, 11000 Belgrade, Serbia
| | - Neda Perunovic
- Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Natasa Pejcic
- Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Jovana Vukovic
- Biocell Hospital, 11070 Beograd, Serbia
- Faculty of Biology, University of Belgrade, 11000 Belgrade, Serbia
| | | | - Danilo Vojvodic
- Institute for Medical Research, Military Medical Academy, 11000 Belgrade, Serbia
| | - Mia Rakic
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense of Madrid, 28040 Madrid, Spain
- Institute for Biological Research “Sinisa Stankovic”, University of Belgrade, 11000 Belgrade, Serbia
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17
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Khodaei T, Schmitzer E, Suresh AP, Acharya AP. Immune response differences in degradable and non-degradable alloy implants. Bioact Mater 2022; 24:153-170. [PMID: 36606252 PMCID: PMC9793227 DOI: 10.1016/j.bioactmat.2022.12.012] [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: 08/31/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Alloy based implants have made a great impact in the clinic and in preclinical research. Immune responses are one of the major causes of failure of these implants in the clinic. Although the immune responses toward non-degradable alloy implants are well documented, there is a poor understanding of the immune responses against degradable alloy implants. Recently, there have been several reports suggesting that degradable implants may develop substantial immune responses. This phenomenon needs to be further studied in detail to make the case for the degradable implants to be utilized in clinics. Herein, we review these new recent reports suggesting the role of innate and potentially adaptive immune cells in inducing immune responses against degradable implants. First, we discussed immune responses to allergen components of non-degradable implants to give a better overview on differences in the immune response between non-degradable and degradable implants. Furthermore, we also provide potential areas of research that can be undertaken that may shed light on the local and global immune responses that are generated in response to degradable implants.
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Affiliation(s)
- Taravat Khodaei
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA
| | - Elizabeth Schmitzer
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA
| | | | - Abhinav P. Acharya
- Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA,Biological Design, Arizona State University, Tempe, AZ, 85281, USA,Chemical Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State, University, Tempe, AZ, 85281, USA,Materials Science and Engineering, School for the Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ, 85281, USA,Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, AZ, 85281, USA,Corresponding author. Biomedical Engineering, School of Biological and Health System Engineering, Arizona State, University, Tempe, AZ, 85281, USA.
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18
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Song L, Jiang J, Li J, Zhou C, Chen Y, Lu H, He F. The Characteristics of Microbiome and Cytokines in Healthy Implants and Peri-Implantitis of the Same Individuals. J Clin Med 2022; 11:5817. [PMID: 36233685 PMCID: PMC9572122 DOI: 10.3390/jcm11195817] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
AIM To characterize the profile of submucosal microbiome and cytokine levels in peri-implant crevicular fluid (PICF) from clinically healthy implants and peri-implantitis in the same individuals. MATERIAL AND METHODS A total of 170 patients were screened and, finally, 14 patients with at least one healthy implant and one peri-implantitis implant were included. Submucosal microbiota and cytokines from 28 implants were analyzed using 16S rRNA gene sequencing and multifactor assays, respectively. Correlations of clinical indexes and microbiota or cytokines were analyzed using Spearman's correlation coefficient. A random forest classification model was constructed. RESULTS Peri-implantitis sites harbored higher microbial diversity, as well as more Gram-negative bacteria and anaerobic bacteria, compared with healthy implants sites. The genera of Peptostreptococcaceae XIG-1, Treponema, Porphyromonas, and Lachnospiraceae G-8, as well as the cytokines of IL-17A, IL-6, IL-15, G-CSF, RANTES, and IL-1β were significantly higher in peri-implantitis than healthy implants. Furthermore, these genera and cytokines had positive relationships with clinical parameters, including probing depth (PD), bleeding on probing (BOP), and marginal bone loss (MBL). The classification model picked out the top 15 biomarkers, such as IL-17A, IL-6, IL-15, VEGF, IL-1β, Peptostreptococcaceae XIG-1, Haemophilus, and Treponema, and obtained an area under the curve (AUC) of 0.85. CONCLUSIONS There are more pathogenic bacteria and inflammatory cytokines in peri-implantitis sites, and biomarkers could facilitate the diagnosis of peri-implantitis.
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Affiliation(s)
| | | | | | | | | | - Hongye Lu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, QiuTao Rd (N), Shangcheng District, Hangzhou 310020, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, QiuTao Rd (N), Shangcheng District, Hangzhou 310020, China
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19
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Nagasawa MA, Formiga MDC, Moraschini V, Bertolini M, Souza JGS, Feres M, Figueiredo LC, Shibli JA. Do the progression of experimentally induced gingivitis and peri-implant mucositis present common features? A systematic review of clinical human studies. BIOFOULING 2022; 38:814-823. [PMID: 36250998 DOI: 10.1080/08927014.2022.2133603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
This systematic review evaluated the features of the progression of experimentally induced gingivitis and peri-implant mucositis in humans. Included were studies that evaluated clinical, immunological, or microbiological responses between experimentally induced gingivitis and peri-implant mucositis in periodontally healthy patients. A total of 887 articles were initially identified, but only 12 were included in the final analysis. Implants accumulate less biofilm and suffer the most heterogeneous alterations in the microbiota, in the abstinence of oral hygiene, compared with the tooth. Interestingly, although dental implants presented less biofilm accumulation, the peri-implant mucosa showed a more exacerbated clinical response than the gingival tissue. The risk of bias of the selected studies was moderate to low, with one study presenting serious risk. The progression events of peri-implant mucositis were similar to those of experimental gingivitis but led to a different host response. This review was registered in the PROSPERO database CRD420201 123360.
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Affiliation(s)
- Magda Aline Nagasawa
- Department of Periodontology, Dental Research Division, University of Guarulhos (UnG), Sao Paulo, Brazil
| | - Márcio de Carvalho Formiga
- Department of Periodontology, Dental Research Division, University of Guarulhos (UnG), Sao Paulo, Brazil
- Department of Periodontology and Oral Implantology, UNISUL, Florianópolis, Brazil
| | - Vittorio Moraschini
- Dental Research Division, Graduate Program at the Veiga de Almeida University, Rio de Janeiro, Brazil
| | - Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - João Gabriel Silva Souza
- Department of Periodontology, Dental Research Division, University of Guarulhos (UnG), Sao Paulo, Brazil
- Dental Science School, Faculdade de Ciências Odontológicas, Montes Claros, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, University of Guarulhos (UnG), Sao Paulo, Brazil
| | - Luciene C Figueiredo
- Department of Periodontology, Dental Research Division, University of Guarulhos (UnG), Sao Paulo, Brazil
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, University of Guarulhos (UnG), Sao Paulo, Brazil
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20
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Luengo F, Solonko M, Sanz-Esporrín J, Sanz-Sánchez I, Herrera D, Sanz M. Clinical, Microbiological, and Biochemical Impact of the Surgical Treatment of Peri-Implantitis-A Prospective Case Series. J Clin Med 2022; 11:jcm11164699. [PMID: 36012939 PMCID: PMC9410201 DOI: 10.3390/jcm11164699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background: The aim of this study, a prospective case series, was to evaluate the clinical, microbiological, and biochemical impact of the surgical treatment of peri-implantitis. Methods: Thirty subjects with diagnosis of peri-implantitis were treated following a surgical protocol including access flaps, surface decontamination with ultrasonics and glycine powder air-polishing, and systemic antibiotics. Disease resolution was defined by the composite outcome including presence of probing depths (PD) ≤5 mm, absence of bleeding on probing (BoP)/suppuration, and no additional radiographic bone loss (>1 mm). Regression analysis was used to evaluate the patient-, implant-, and prosthetic-related factors possibly influencing treatment outcomes. Results: Patients were evaluated at 6 months post treatment, demonstrating statistically significant reductions in PD (2.14 ± 1.07 mm) and increase in mucosal recession (1.0 ± 0.77 mm). Plaque, BoP, and suppuration were also reduced by 40.56%, 62.22%, and 7.78%, respectively. Disease resolution was achieved in 56.67% of patients. No significant changes were detected in microbiological parameters except for a significant reduction in proportions of Parvimonas micra. Similarly, the levels of the biomarker interleukin-8 in crevicular fluid were significantly lower at 6 months. Conclusions: The proposed surgical treatment of peri-implantitis demonstrated statistically significant clinical improvements although the impact on microbiological and biochemical parameters was scarce.
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Affiliation(s)
- Fernando Luengo
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Myroslav Solonko
- Section of Periodontology, Faculty of Odontology, University Complutense, 28040 Madrid, Spain
| | - Javier Sanz-Esporrín
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
- Correspondence:
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
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21
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Martins LRL, Grzech-Leśniak K, Castro dos Santos N, Suárez LJ, Giro G, Bastos MF, Shibli JA. Transcription Factor AhR, Cytokines IL-6 and IL-22 in Subjects with and without Peri-Implantitis: A Case Control-Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7434. [PMID: 35742682 PMCID: PMC9224299 DOI: 10.3390/ijerph19127434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/11/2022] [Accepted: 05/24/2022] [Indexed: 01/27/2023]
Abstract
Peri-implantitis is a plaque-associated condition characterized by mucosal inflammation and subsequent progressive loss of supporting bone; it is caused by bacterial biofilm, but the host response triggered by bacterial stimulation promotes the release of cells and mediators that culminate in tissue destruction. The Aryl-hydrocarbon Receptor (AhR) is associated with IL-22 production by Th22 and Th17 CD4+ Th cells. The presence of IL-6 may promote the Th22 phenotype. The present case-control study evaluated the gene expression of AhR, IL-22, and IL-6 in the peri-implant tissues of healthy and peri-implantitis patients. Tissue biopsies were collected from thirty-five volunteers (15 healthy and 20 with peri-implantitis). A real-time PCR reaction was utilized to assess the AhR, IL-22, and IL-6 gene expression levels relative to the reference gene (GAPDH). The results were analyzed using the Mann-Whitney test with a significance level of 5%. Higher levels of gene expression of AhR and IL-6 were detected in peri-implantitis tissues. The IL-22 gene expression levels did not differ between groups. In conclusion, higher gene expression levels for AhR and IL-6 were detected in the soft tissues of peri-implantitis patients. IL-22 did not vary between conditions, which may indicate the loss of the immunomodulatory role of IL-22 in periimplantitis.
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Affiliation(s)
- Luis Ricardo Linard Martins
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
| | - Kinga Grzech-Leśniak
- Laser Laboratory at Dental Surgery Department, Medical University of Wroclaw, 50-425 Wroclaw, Poland;
| | - Nidia Castro dos Santos
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Lina J. Suárez
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
- Departamento de Ciencias Básicas y Medicina Oral, Universidad Nacional de Colombia, Cra 45 # 26-85, Bogota 11001, Colombia
| | - Gabriela Giro
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
| | - Marta Ferreira Bastos
- Programa de Pós Graduação em Ciências do Envelhecimento, Universidade São Judas Tadeu, Rua Taquari, 546, Sao Paulo 03166-000, Brazil;
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
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22
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Feres M, Duarte PM, Figueiredo LC, Gonçalves C, Shibli J, Retamal-Valdes B. Systematic and scoping reviews to assess biological parameters. J Clin Periodontol 2022; 49:884-888. [PMID: 35713237 DOI: 10.1111/jcpe.13681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/18/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The evidence synthesis approach compiling biological/laboratory data is effective in advancing health-related knowledge. However, this approach is still underused in the oral health field. METHODS This Commentary discusses the opportunities and challenges of systematic and scoping reviews of laboratory data in dentistry. Special focus is put on the potential of these reviews to elucidate etiological and treatment concepts of oral diseases, such as periodontitis and periimplantitis. RESULTS The following difficulties associated with such studies are discussed: (i) selection of ideal study design, (ii) assessment of "risk of bias" and definition of "certainty of evidence", (iii) evidence assembly and summary, and (iv) paper review process. DISCUSSION Despite those challenges, high-quality reviews integrating laboratory data may generate relevant scientific information and help identify new avenues for future investigations. Experts in different oral health topics should build a process capable of helping researchers assemble and interpret these types of data.
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Affiliation(s)
- Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil.,The Forsyth Institute, Cambridge, MA, USA
| | - Poliana Mendes Duarte
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil.,Department of Periodontology, School of Advanced Dental Sciences, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Luciene C Figueiredo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Cristiane Gonçalves
- Department of Periodontology, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Jamil Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
| | - Belen Retamal-Valdes
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
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23
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Chen CY, Tsai PH, Lin YH, Huang CY, Chung JHY, Chen GY. Controllable graphene oxide-based biocompatible hybrid interface as an anti-fibrotic coating for metallic implants. Mater Today Bio 2022; 15:100326. [PMID: 35761844 PMCID: PMC9233272 DOI: 10.1016/j.mtbio.2022.100326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 11/27/2022] Open
Abstract
In tissue engineering, foreign body reactions (FBRs) that may occur after the insertion of medical implants are a considerable challenge. Materials currently used in implants are mainly metals that are non-organic, and the lack of biocompatibility and absence of immune regulations may lead to fibrosis after long periods of implantation. Here, we introduce a highly biocompatible hybrid interface of graphene oxide (GO) and collagen type I (COL-I), where the topological nanostructure can effectively inhibit the differentiation of fibroblasts into myofibroblasts. The structure and roughness of this coating interface can be easily adjusted at the nanoscale level through changes in the GO concentration, thereby effectively inducing the polarization of macrophages to the M1 state without producing excessive amounts of pro-inflammatory factors. Compared to nanomaterials or the extracellular matrix as an anti-fibrotic interface, this hybrid bio-interface has superior mechanical strength, physical structures, and high inflammation. Evidenced by inorganic materials such as glass, titanium, and nitinol, GO-COL shows great potential for use in medical implants and cell-material interfaces.
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Affiliation(s)
- Chong-You Chen
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, 300093, Taiwan.,Department of Electronics and Electrical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, 300093, Taiwan
| | - Pei-Hsuan Tsai
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, 300093, Taiwan
| | - Ya-Hui Lin
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, 300093, Taiwan
| | - Chien-Yu Huang
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, 300093, Taiwan.,Department of Electronics and Electrical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, 300093, Taiwan
| | - Johnson H Y Chung
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, University of Wollongong, Wollongong, NSW, 2500, Australia
| | - Guan-Yu Chen
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, 300093, Taiwan.,Department of Electronics and Electrical Engineering, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, 300093, Taiwan
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24
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Network pharmacology combined with GEO database identifying the mechanisms and molecular targets of Polygoni Cuspidati Rhizoma on Peri-implants. Sci Rep 2022; 12:8227. [PMID: 35581339 PMCID: PMC9114011 DOI: 10.1038/s41598-022-12366-3] [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: 02/03/2022] [Accepted: 05/10/2022] [Indexed: 11/08/2022] Open
Abstract
Peri-implants is a chronic disease leads to the bone resorption and loss of implants. Polygoni Cuspidati Rhizoma (PCRER), a traditional Chinese herbal has been used to treat diseases of bone metabolism. However, its mechanism of anti-bone absorption still remains unknown. We aimed to identify its molecular target and the mechanism involved in PCRER potential treatment theory to Peri-implants by network pharmacology. The active ingredients of PCRER and potential disease-related targets were retrieved from TCMSP, Swiss Target Prediction, SEA databases and then combined with the Peri-implants disease differential genes obtained in the GEO microarray database. The crossed genes were used to protein–protein interaction (PPI) construction and Gene Ontology (GO) and KEGG enrichment analysis. Using STRING database and Cytoscape plug-in to build protein interaction network and screen the hub genes and verified through molecular docking by AutoDock vina software. A total of 13 active compounds and 90 cross targets of PCRER were selected for analysis. The GO and KEGG enrichment analysis indicated that the anti-Peri-implants targets of PCRER mainly play a role in the response in IL-17 signaling, Calcium signaling pathway, Toll-like receptor signaling pathway, TNF signaling pathway among others. And CytoHubba screened ten hub genes (MMP9, IL6, MPO, IL1B, SELL, IFNG, CXCL8, CXCL2, PTPRC, PECAM1). Finally, the molecular docking results indicated the good binding ability with active compounds and hub genes. PCRER’s core components are expected to be effective drugs to treat Peri-implants by anti-inflammation, promotes bone metabolism. Our study provides new thoughts into the development of natural medicine for the prevention and treatment of Peri-implants.
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25
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Yuan S, Wang C, Jiang W, Wei Y, Li Q, Song Z, Li S, Sun F, Liu Z, Wang Y, Hu W. Comparative Transcriptome Analysis of Gingival Immune-Mediated Inflammation in Peri-Implantitis and Periodontitis Within the Same Host Environment. J Inflamm Res 2022; 15:3119-3133. [PMID: 35642216 PMCID: PMC9148613 DOI: 10.2147/jir.s363538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/13/2022] [Indexed: 01/10/2023] Open
Affiliation(s)
- Shasha Yuan
- Department of Periodontology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - Cui Wang
- Department of Periodontology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - Wenting Jiang
- Department of Periodontology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - Yiping Wei
- Department of Periodontology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - Qingqing Li
- Department of Immunology, School of Basic Medical Sciences, and NHC Key Laboratory of Medical Immunology, Peking University, Beijing, People’s Republic of China
- Center for Human Disease Genomics, Peking University, Beijing, People’s Republic of China
| | - Zhanming Song
- Department of Immunology, School of Basic Medical Sciences, and NHC Key Laboratory of Medical Immunology, Peking University, Beijing, People’s Republic of China
- Center for Human Disease Genomics, Peking University, Beijing, People’s Republic of China
| | - Siqi Li
- Department of Periodontology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - Fei Sun
- Department of Periodontology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - Zhongtian Liu
- Department of Immunology, School of Basic Medical Sciences, and NHC Key Laboratory of Medical Immunology, Peking University, Beijing, People’s Republic of China
- Center for Human Disease Genomics, Peking University, Beijing, People’s Republic of China
| | - Ying Wang
- Department of Immunology, School of Basic Medical Sciences, and NHC Key Laboratory of Medical Immunology, Peking University, Beijing, People’s Republic of China
- Center for Human Disease Genomics, Peking University, Beijing, People’s Republic of China
- Correspondence: Ying Wang, Department of Immunology, School of Basic Medical Sciences, and NHC Key Laboratory of Medical Immunology, Peking University, No. 38, College Road, Haidian District, Beijing, People’s Republic of China, Tel +86 10 8280115, Email
| | - Wenjie Hu
- Department of Periodontology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, People’s Republic of China
- Wenjie Hu, Department of Periodontology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Street, Haidian District, Beijing, People’s Republic of China, Tel +86 10 82195374, Email
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26
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Nrf2 in the Field of Dentistry with Special Attention to NLRP3. Antioxidants (Basel) 2022; 11:antiox11010149. [PMID: 35052653 PMCID: PMC8772975 DOI: 10.3390/antiox11010149] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 02/06/2023] Open
Abstract
The aim of this review article was to summarize the functional implications of the nuclear factor E2-related factor or nuclear factor (erythroid-derived 2)-like 2 (Nrf2), with special attention to the NACHT (nucleotide-binding oligomerization), LRR (leucine-rich repeat), and PYD (pyrin domain) domains-containing protein 3 (NLRP3) inflammasome in the field of dentistry. NLRP3 plays a crucial role in the progression of inflammatory and adaptive immune responses throughout the body. It is already known that this inflammasome is a key regulator of several systemic diseases. The initiation and activation of NLRP3 starts with the oral microbiome and its association with the pathogenesis and progression of several oral diseases, including periodontitis, periapical periodontitis, and oral squamous cell carcinoma (OSCC). The possible role of the inflammasome in oral disease conditions may involve the aberrant regulation of various response mechanisms, not only in the mouth but in the whole body. Understanding the cellular and molecular biology of the NLRP3 inflammasome and its relationship to Nrf2 is necessary for the rationale when suggesting it as a potential therapeutic target for treatment and prevention of oral inflammatory and immunological disorders. In this review, we highlighted the current knowledge about NLRP3, its likely role in the pathogenesis of various inflammatory oral processes, and its crosstalk with Nrf2, which might offer future possibilities for disease prevention and targeted therapy in the field of dentistry and oral health.
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27
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Lashkarizadeh N, Foroudisefat M, Abyari S, Mohammadi M, Lashkarizadeh L. Is It Safe To Reuse Healing Abutments? An Experimental Study on IL-1β and TNF-α Cytokine Levels in Peri-Implant Crevicular Fluid. J Prosthodont 2021; 31:399-404. [PMID: 34962679 DOI: 10.1111/jopr.13474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 11/30/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To compare pro-inflammatory cytokine levels in the peri-implant crevicular fluid (PICF) in unused and reused healing abutments. MATERIALS AND METHOD This study was a controlled randomized, double-blind clinical trial. Seventy-two patients who met the inclusion criteria were divided into two groups. After one-stage implant placement, in group A, an unused healing abutment, and in group B, a reused healing abutment, was connected to the implant fixture. After 2 months, clinical measurements for keratinized gingiva (KG), plaque index (PI), and bleeding index (BI) (Ainamo and Bay) were taken, and PICF sampling was performed to evaluate pro-inflammatory IL-1β and TNF-α cytokine levels using the ELISA test. Comparison of clinical measurements and cytokine levels between the two study groups was made using the Mann-Whitney test. RESULT Clinical measurements and sampling were performed on 60 patients (nA = 27, nB = 33). There was no significant difference between the two groups in clinical measurements (BI (p-value=0.96) and PI (p-value=0.06)) or TNF-α (p-value=0.63) and IL-1β (p-value=0.26) cytokine levels. CONCLUSION Reused healing abutments that are cleaned and sterilized properly do not appear to induce further peri-implant pro-inflammatory response; therefore, they can be utilized temporarily until implant abutment insertion. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Nazila Lashkarizadeh
- Oral and Dental Diseases Research Center and Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrnaz Foroudisefat
- Oral and Dental Diseases Research Center and Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Sina Abyari
- Oral and Dental Diseases Research Center and Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Mohammadi
- Oral and Dental Diseases Research Center and Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Lida Lashkarizadeh
- Oral and Dental Diseases Research Center and Department of Periodontics, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
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28
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Wang IC, Ou A, Johnston J, Giannobile WV, Yang B, Fenno JC, Wang HL. Association between Peri-implantitis and Cardiovascular Diseases: A Case-control Study. J Periodontol 2021; 93:633-643. [PMID: 34724214 DOI: 10.1002/jper.21-0418] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 11/07/2022]
Abstract
AIM To assess the association between peri-implantitis and cardiovascular diseases (CVD). METHODS 128 patients with dental implants were recruited to evaluate the prevalence of peri-implantitis in patients with or without CVD (Cases, n = 82, Controls, n = 46, respectively). Diagnosis of peri-implantitis followed the 2017 World Workshop guideline and the severity was defined as mild, moderate, and severe form when the radiographic bone loss (RBL) was < 2mm, 2-4mm, and > 4 mm. Multivariable logistic regression was performed to test the association between two diseases. RESULTS A trend of higher prevalence of peri-implantitis defined by detectable RBL beyond the physiologic bone remodeling was found in the "Cases" group (64.6%) when compared to the "Controls" (56.5%). A significant higher prevalence (48.8%) of moderate to severe peri-implantitis was identified in "Cases" compared to "Controls"(30.4%) with a significant crude association between moderate to severe peri-implantitis and CVD (odds ratio = 2.18, 95% CI = 1.02 to 4.67, p = 0.04). The CVD group had a trend of higher prevalence of deep pockets (≥ 7mm) and higher numbers of sites with bleeding upon probing (BOP) (> 66%) when compared to "Controls" (p> 0.05). However, after controlling for multiple confounders including age, hypertension, smoking, family history of heart attack, and periodontitis, the significant association was not found. CONCLUSIONS CVD group had significantly higher prevalence of moderate to severe peri-implantitis (RBL ≥ 2mm). The association between the two diseases did not exist after controlling multiple confounders for CVD. Future studies with a larger sample size controlling for the patient- and implant-related confounders are needed to better understand the link between peri-implantitis and cardiovascular disease. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- I-Ching Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Currently, Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Alice Ou
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Jeffery Johnston
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Vice President, Chief Science Officer, and Director of the Research and Data Institute at Delta Dental of Michigan
| | - William V Giannobile
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Currently, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Bo Yang
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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29
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Rathe F, Junker R, Gröger S, Meyle J, Schlee M. Inflammatory effects of individualized abutments bonded onto titanium base on peri-implant tissue health: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2021; 23:874-882. [PMID: 34668304 DOI: 10.1111/cid.13050] [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: 05/18/2021] [Revised: 08/29/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND In implant prosthodontics, computer-assisted design and computer-assisted manufacturing (CAD/CAM) zirconia abutments bonded onto titanium bases are frequently used in prosthetic dentistry. Unpolymerized monomer of the bonding material or the adhesive gap itself may have a negative effect on peri-implant tissue health. However, evidence addressing this problem is not available. PURPOSE The aim of the current trial was to study inflammatory effects of individualized abutments bonded onto titanium bases. MATERIAL AND METHOD A total of 24 patients with one test abutment and one control abutment each participated in this prospective, double-blind, randomized controlled clinical trial. Thereby, test abutments were CAD/CAM titanium abutments bonded onto titanium abutments (Ti-Base). As control abutments individualized, one-piece CAD/CAM titanium abutments were used. At abutment installation as well as 6 and 12 months thereafter bone level changes, clinical parameters as well as Il-1β levels were assessed. RESULTS Neither for bone level or clinical parameters nor for Il-1β levels, significant differences between test and control abutments could be found. However, in both groups Il-1β levels were significantly elevated at both the 6 and 12 months follow-up compared to baseline. CONCLUSION Within the limits of this RCT, it can be concluded that effects on the inflammatory state of peri-implant tissues do not differ between individualized abutments bonded onto Ti-Bases and individualized one-piece abutments.
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Affiliation(s)
- Florian Rathe
- Department of Prosthodontics and Biomaterials, DANUBE Private University, Krems an der Donau, Austria.,Private Office of Implantology and Periodontology, Forchheim, Germany
| | - Rüdiger Junker
- Department of Prosthodontics and Biomaterials, DANUBE Private University, Krems an der Donau, Austria
| | - Sabine Gröger
- Department of Periodontology, Justus Liebig-University, Gießen, Germany
| | - Jörg Meyle
- Department of Periodontology, Justus Liebig-University, Gießen, Germany
| | - Markus Schlee
- Private Office of Implantology and Periodontology, Forchheim, Germany.,Department of Maxillofacial Surgery, Johann Wolfgang von Goethe University, Frankfurt, Germany
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Jin Q, Teng F, Cheng Z. Association between common polymorphisms in IL-1 and TNFα and risk of peri-implant disease: A meta-analysis. PLoS One 2021; 16:e0258138. [PMID: 34610045 PMCID: PMC8491952 DOI: 10.1371/journal.pone.0258138] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/20/2021] [Indexed: 11/19/2022] Open
Abstract
Background Pro-inflammatory cytokines interleukin-1 (IL-1) and tumor necrosis factor α (TNFα) play important roles in host immune response and bone metabolism during dental implant osseointegration. Whether the functional polymorphisms in IL-1α, IL-1β and TNFα were associated with peri-implant disease was unclear, and we performed the present meta-analysis for this purpose. Methods Eligible studies investigating IL-1α C-889T, IL-1β C+3954T and C-511T, TNFα G-308A, composite genotype of IL-1α C-889T and IL-1β C+3954T for association with peri-implant disease, including peri-implantitis (PI), marginal bone loss (MBL) and implant failure/loss (IF/IL), were searched on several literature databases prior to April 30, 2021. Odds ratio (OR) and corresponding 95% confidence interval (CI) were calculated for each polymorphism in different genetic models and for composite genotype comparing carriers to non-carriers. Results Twenty-seven studies (1324 cases with peri-implant disease and 1808 controls with healthy implants) were included. There was significant correlation between IL-1α C-889T and peri-implant disease in all genetic models. IL-1β C+3954T was associated with peri-implant disease risk in allelic (OR = 1.66, 95%CI 1.17–2.35, p = 0.004) and dominant model (OR = 1.74, 95%CI 1.19–2.53, p = 0.004), and in subgroups of Asians, Caucasians, non-smokers, IF/IL and PI. TT genotype of IL-1β C-511T increased the risk of peri-implant disease (OR = 1.68, 95%CI 1.15–2.43, p = 0.007) and MBL (OR = 4.33, 95%CI 1.72–10.9, p = 0.002) compared to CC+CT genotypes. We did not observed a significant association between TNFα G-308A and peri-implant diseases in overall or subgroups analysis. Carriers of positive composite genotype of IL-1α C-889T and IL-1β C+3954T had 1.95-fold (95%CI 1.35–2.80, p<0.001) risk of peri-implant disease and 1.76-fold (95%CI 1.05–2.95, p = 0.032) risk of IF/IL than non-carriers. Conclusion Functional polymorphisms of IL-1α (C-889T), IL-1β (C+3954T, C-511T) and composite genotype of IL-1 can be used as predictive markers for peri-implant disease, whereas TNFα G-308A polymorphism was not associated with peri-implant disease.
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Affiliation(s)
- Qiuchen Jin
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fangjun Teng
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhigang Cheng
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail:
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31
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Milinkovic I, Djinic Krasavcevic A, Nikolic N, Aleksic Z, Carkic J, Jezdic M, Jankovic S, Milasin J. Notch down-regulation and inflammatory cytokines and RANKL overexpression involvement in peri-implant mucositis and peri-implantitis: A cross-sectional study. Clin Oral Implants Res 2021; 32:1496-1505. [PMID: 34546593 DOI: 10.1111/clr.13850] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/01/2021] [Accepted: 07/07/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Notch signaling pathway, known to influence bone resorption in several oral diseases, has not been analyzed in peri-implantitis yet. Therefore, the aims of the present study were to determine the levels of Notch cascade, bone remodeling mediators, and pro-inflammatory cytokines, in conjunction with clinical parameters, in subjects with peri-implant mucositis and peri-implantitis. MATERIAL AND METHODS Clinical parameters: peri-implant probing depth, bleeding on probing, suppuration on probing, and plaque index (PI) were recorded. Samples were collected from 130 participants, divided into peri-implantitis (PI), peri-implant mucositis (PM), and healthy implants (HI) group. Relative expression levels (REL) of Notch 1, Notch 2, Jagged 1, Hes 1, Hey 1, TNF-α, IL-17, IL-1β, IL-6, RANKL, and OPG mRNA were determined by reverse transcriptase-real-time polymerase chain reaction. Quantitation of Notch 1, Il-17, and IL-6 proteins was performed using ELISA assays. RESULTS All clinical parameters were significantly higher in PI compared to HI. Significant decrease of Notch 1, and higher REL of Hey 1, IL-1β, IL-6, and RANKL were found in PI compared to HI. PM showed significant increase of IL-1β REL in comparison with HI. In PI versus PM, significantly higher REL was found for Hey 1, TNF-α, IL-17, IL-1β, IL-6, and RANKL. Additionally, higher protein concentrations of IL-6 and IL-17 were detected in PI versus PM and versus HI group. CONCLUSION The combined effect of Notch 1 down-regulation and elevated expression of some key inflammation modulators might result in osteoclast activity increase and subsequent osteolysis in peri-implantitis.
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Affiliation(s)
- Iva Milinkovic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Djinic Krasavcevic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Nadja Nikolic
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Aleksic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Carkic
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Jezdic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Sasha Jankovic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Milasin
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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32
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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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Association of Self-Rated Pain with Clinical Peri-Implant Parameters and Cytokine Profile in Smokers and Never Smokers with and without Peri-Implantitis. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11125559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To examine the association between self-perceived pain (SPP), clinical and radiographic peri-implant parameters, and biomarker levels among smokers and never smokers with and without peri-implantitis. Sixty individuals (20 smokers with peri-implantitis [group-1], 20 never smokers with peri-implantitis [group-2] and 20 never smokers without peri-implantitis [control-group]) were included. SPP was evaluated using a numeric pain rating scale (NPRS). Peri-implant plaque index (PI), probing depth (PD), and bleeding on probing (BOP) were recorded. After obtaining the samples, the levels of TNF-α, MMP-1, and IL-8 were measured. The mean SPP score in group-1, group-2, and the control group was 1.3 ± 1, 3.4 ± 1, and zero, respectively. The peri-implant mean PD (p < 0.05), BOP (p < 0.05), PI (p < 0.05), and crestal bone loss (CBL) (p < 0.05) were significantly higher among test groups than the control group. The levels of TNF-α, MMP-1, and IL-8 were significantly raised among group-1 and group-2 than the control group. A significant correlation between increasing SPP and PICF TNF-α, MMP-1, and IL-8 levels was observed based on regression analysis. Proinflammatory biomarkers were higher in smokers with peri-implantitis than never smokers with and without peri-implantitis, with a significant association between the proinflammatory cytokines and SPP.
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Iglhaut G, Salomon S, Fretwurst T, Thomas P, Endres J, Kessler S, Summer B. Cross-sectional evaluation of clinical and immunological parameters at partially microgrooved vs machined abutments in humans. Int J Implant Dent 2021; 7:46. [PMID: 34031775 PMCID: PMC8144255 DOI: 10.1186/s40729-021-00329-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/18/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The objective of the present study was to examine the clinical and immunological parameters in samples collected from the peri-implant crevicular fluid (PICF) of machined titanium (M) abutments compared to titanium abutments with a laser-microtextured surface (LMS) on dental implants. MATERIAL AND METHODS A total of 40 patients with one titanium implant, half of them (n=20) provided with a M abutment (control group) and the other half (n=20) with LMS abutments (test group), were included in the study. Clinical parameters pocket probing depth (PD), full-mouth plaque score (FMPS), radiographic bone loss (RBL), clinical attachment level (CAL), mucosal recession (MR), bleeding on probing (BOP), and width of keratinized mucosa (KM) were evaluated. The peri-implant sulcus fluid was analyzed for cytokines IL-1α, IL-1β, IL-6, IL-8, and IL-10 via flow cytometry. RESULTS Clinical evaluation demonstrated no significant difference of PD (mean LMS = 3.50 mm/SD 0.95 mm vs mean M = 3.45 mm/SD 0.76 mm (p=0.855)), MR (mean LMS = 0.30 mm/SD 0.57 mm vs mean M = 0.35 mm/SD 0.67 mm (p=0.801)), CAL (mean LMS = 3.60 mm/SD 1.14 mm vs mean M = 3.55 mm/SD 0.89 mm (p=0.878)), and KM (mean LMS = 2.03 mm/SD 1.08 mm vs mean M = 2.13 mm/SD 0.92 mm (p=0.754)) between LMS and M abutments. LMS abutments showed less BOP than M abutments (26.7% vs 30.8%), but statistically not significant (p = 0.2235). Radiographic bone loss (mean LMS = 0.22 mm/SD 0.44 mm vs mean M = 0.59 mm/SD 0.49 mm) was reduced in the test group in comparison with the control group (p=0.016). In the collected PICF, the levels of pro-inflammatory cytokines IL-1α (median LMS = 180.8 pg/ml vs M = 200.9 pg/ml (p=0.968)) and IL-1β (median LMS = 60.43 pg/ml vs M = 83.11 pg/ml (p=0.4777)) were lower, and the levels of IL-6 (median LMS = 180.8 pg/ml vs M = 200.9 pg/ml (p<0.0001)) were significantly lower in the test group. In contrast, the levels of IL-8 (median LMS = 255.7 pg/ml vs M = 178.7 pg/ml (p=0.3306)) were higher in the test group, though not significantly. The levels of anti-inflammatory IL-10 were significantly increased in the test group (LMS median = 0.555 pg/ml vs M median = 0.465 pg/ml (p=0.0365)). IL-1β showed a significant correlation to radiologic bone loss (p=0.0024). The other variables IL-1α, IL-6, IL-8, and IL-10 had no significant correlation to radiological bone loss. CONCLUSION Within the limitations of this study, titanium implants provided with laser-microtextured surface abutments seem to demonstrate less pro-inflammatory and more anti-inflammatory activity and to show reduced radiographic bone loss compared to machined titanium abutments. CLINICAL RELEVANCE The use of laser-microtextured surface abutments might have the potential to support peri-implant tissue health.
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Affiliation(s)
- Gerhard Iglhaut
- Department of Oral and Craniomaxillofacial Surgery, Translational Implantology, Center for Dental Medicine, University Medical Center of Freiburg, Freiburg, Germany. .,Private Center of Oral Surgery, Bahnhofstrasse 20, 87700, Memmingen, Germany.
| | | | - Tobias Fretwurst
- Department of Oral and Craniomaxillofacial Surgery, Translational Implantology, Center for Dental Medicine, University Medical Center of Freiburg, Freiburg, Germany
| | - Peter Thomas
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Janina Endres
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Selina Kessler
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Burkhard Summer
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
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Menini M, Dellepiane E, Pera F, Izzotti A, Baldi D, Delucchi F, Bagnasco F, Pesce P. MicroRNA in Implant Dentistry: From Basic Science to Clinical Application. Microrna 2021; 10:14-28. [PMID: 33970853 DOI: 10.2174/2211536610666210506123240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/13/2021] [Accepted: 03/18/2021] [Indexed: 11/22/2022]
Abstract
Specific microRNA (miRNA) expression profiles have been reported to be predictive of specific clinical outcomes of dental implants and might be used as biomarkers in implant dentistry with diagnostic and prognostic purposes. The aim of the present narrative review was to summarize current knowledge regarding the use of miRNAs in implant dentistry. The authors attempted to identify all available evidence on the topic and critically appraise it in order to lay the foundation for the development of further research oriented towards the clinical application of miRNAs in implant dentistry.
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Affiliation(s)
- Maria Menini
- Division of Fixed and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy
| | - Elena Dellepiane
- Division of Fixed and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy
| | - Francesco Pera
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alberto Izzotti
- Department of Health Sciences, University of Genoa, Genova, Italy
| | - Domenico Baldi
- Division of Fixed and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy
| | - Francesca Delucchi
- Division of Fixed and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy
| | - Francesco Bagnasco
- Division of Fixed and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy
| | - Paolo Pesce
- Division of Fixed and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy
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36
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Pranno N, Cristalli MP, Mengoni F, Sauzullo I, Annibali S, Polimeni A, La Monaca G. Comparison of the effects of air-powder abrasion, chemical decontamination, or their combination in open-flap surface decontamination of implants failed for peri-implantitis: an ex vivo study. Clin Oral Investig 2021; 25:2667-2676. [PMID: 32975703 PMCID: PMC8060238 DOI: 10.1007/s00784-020-03578-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/07/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare, using an ex vivo model, the biofilm removal of three surface decontamination methods following surgical exposure of implants failed for severe peri-implantitis. MATERIALS AND METHODS The study design was a single-blind, randomized, controlled, ex vivo investigation with intra-subject control. Study participants were 20 consecutive patients with at least 4 hopeless implants, in function for >12 months and with progressive bone loss exceeding 50%, which had to be explanted. Implants of each patient were randomly assigned to the untreated control group or one of the three decontamination procedures: mechanical debridement with air-powder abrasion, chemical decontamination with hydrogen peroxide and chlorhexidine gluconate, or combined mechanical-chemical decontamination. Following surgical exposure, implants selected as control were retrieved, and afterwards, test implants were decontaminated according to allocation and carefully explanted with a removal kit. Microbiological analysis was expressed in colony-forming-units (CFU/ml). RESULTS A statistically significant difference (p < 0.001) in the concentrations of CFU/ml was found between implants treated with mechanical debridement (531.58 ± 372.07) or combined mechanical-chemical decontamination (954.05 ± 2219.31) and implants untreated (37,800.00 ± 46,837.05) or treated with chemical decontamination alone (29,650.00 ± 42,596.20). No statistically significant difference (p = 1.000) was found between mechanical debridement used alone or supplemented with chemical decontamination. Microbiological analyses identified 21 microbial species, without significant differences between control and treatment groups. CONCLUSIONS Bacterial biofilm removal from infected implant surfaces was significantly superior for mechanical debridement than chemical decontamination. CLINICAL RELEVANCE The present is the only ex vivo study based on decontamination methods for removing actual and mature biofilm from infected implant surfaces in patients with peri-implantitis.
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Affiliation(s)
- Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, Sapienza University of Rome, 6. Caserta St., 00161, Rome, Italy.
| | - Fabio Mengoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Ilaria Sauzullo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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López-Valverde N, Macedo-de-Sousa B, López-Valverde A, Ramírez JM. Effectiveness of Antibacterial Surfaces in Osseointegration of Titanium Dental Implants: A Systematic Review. Antibiotics (Basel) 2021; 10:antibiotics10040360. [PMID: 33800702 PMCID: PMC8066819 DOI: 10.3390/antibiotics10040360] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/15/2022] Open
Abstract
Titanium (Ti) dental implant failure as a result of infection has been established at 40%, being regarded as one of the most habitual and untreatable problems. Current research is focused on the design of new surfaces that can generate long-lasting, infection-free osseointegration. The purpose of our study was to assess studies on Ti implants coated with different antibacterial surfaces, assessing their osseointegration. The PubMed, Web of Science and Scopus databases were electronically searched for in vivo studies up to December 2020, selecting six studies that met the inclusion criteria. The quality of the selected studies was assessed using the ARRIVE (Animal Research: Reporting of In Vivo Experiments) criteria and Systematic Review Center for Laboratory animal Experimentation's (SYRCLE's) risk of bias tool. Although all the included studies, proved greater osseointegration capacity of the different antibacterial surfaces studied, the methodological quality and experimental models used in some of them make it difficult to draw predictable conclusions. Because of the foregoing, we recommend caution when interpreting the results obtained.
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Affiliation(s)
- Nansi López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain;
| | - Bruno Macedo-de-Sousa
- Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, Polo I-Edifício Central Rua Larga, 3004-504 Coimbra, Portugal;
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain;
- Correspondence:
| | - Juan Manuel Ramírez
- Department of Morphological Sciences, University of Cordoba, Avenida Menéndez Pidal S/N, 14071 Cordoba, Spain;
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Saremi L, Shafizadeh M, Esmaeilzadeh E, Ghaffari ME, Mahdavi MH, Amid R, Kadkhodazadeh M. Assessment of IL-10, IL-1ß and TNF-α gene polymorphisms in patients with peri-implantitis and healthy controls. Mol Biol Rep 2021; 48:2285-2290. [PMID: 33689092 DOI: 10.1007/s11033-021-06253-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/24/2021] [Indexed: 11/26/2022]
Abstract
Peri-implantitis (PI) is a multifactorial condition caused by the interactions of pathogens and the host immune response. Previous studies have demonstrated a relationship between PI and specific gene polymorphisms, particularly cytokine genes involved in the pathogenesis of PI. This study aimed to evaluate the frequency of single nucleotide polymorphisms (SNPs) of interleukin-10 (IL-10), interleukin 1ß (IL-1ß), and tumor necrosis factor-α (TNF-α) genes in PI patients and healthy controls. A total of 50 patients with PI and 89 periodontally healthy controls were recruited for this study. Venous blood samples (5 cc) were collected, and DNA was extracted. After DNA purification, the relevant gene segments were amplified by polymerase chain reaction (PCR). Restriction fragment length polymorphism (RFLP) and electrophoresis were performed to assess the polymorphisms of the related genes. The analysis revealed that allele and genotype frequencies of IL-10 ─ 819 C/T, IL-10 ─ 592 C/A, and IL-1ß + 3954 C/T significantly differed between PI patients and healthy controls. The analysis revealed no significant association between TNF-α ─ 857 G/A and TNF-α ─ 308 G/A polymorphisms and PI. Our results indicated that specific gene polymorphisms of IL-10 ─ 819 C/T, IL-10 ─ 592 C/A, and IL-1ß + 3954 C/T may play a role in the pathogenesis of PI, and increase its risk of occurrence.
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Affiliation(s)
- Leila Saremi
- Dental Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Marziyeh Shafizadeh
- Dental Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Ebrahim Ghaffari
- Dental Sciences and Research Center, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Hosein Mahdavi
- Periodontics Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Periodontics Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Dental Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Jansson L, Lundmark A, Modin C, Abadji D, Yucel-Lindberg T. Intra-individual cytokine profile in peri-implantitis and periodontitis: A cross-sectional study. Clin Oral Implants Res 2021; 32:559-568. [PMID: 33595852 DOI: 10.1111/clr.13725] [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: 02/23/2020] [Revised: 12/27/2020] [Accepted: 01/27/2021] [Indexed: 12/19/2022]
Abstract
AIM To study cytokine profiles and intra-individual correlations in crevicular fluid samples at periodontitis, peri-implantitis, and healthy sites. MATERIALS AND METHODS Samples from gingival crevicular fluid (GCF) and peri-implant crevicular fluid (PICF) were collected from healthy and diseased sites in patients who had had dental implants for a minimum of 10 years. Cytokine levels were analyzed using the Bio-Plex Pro Human inflammation kit, which included biomarkers for the tumor necrosis factor-α (TNF-α) superfamily, regulatory T Cell (Treg) cytokines, and interferon (IFN) proteins. RESULTS Gingival crevicular fluid/PICF cytokine levels, determined in samples from 163 patients, were frequently lower for healthy tooth and implant sites compared to sites with periodontitis or peri-implantitis. In contrast, there were no significant differences in cytokine levels between peri-implant sites and periodontitis sites. Intra-individual correlations between cytokines at peri-implant sites were frequently significant. In addition, the cytokines IFN-λ1 and TNFSF12 were significantly correlated with the presence of peri-implantitis. CONCLUSION Within the limits of this study, the intra-individual cytokine profile did not differ between sites diagnosed with periodontitis and those diagnosed with peri-implantitis, but did differ between healthy tooth and healthy implant sites. Studying intra-individual cytokine profiles is a method to elucidate possible differences between the etiopathogeneses of periodontitis and peri-implantitis, since it is well known that immune responses to dysbiosis vary between individuals according to host factors. Thus, the findings of the present study are potentially relevant to the advancement of knowledge in this field.
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Affiliation(s)
- Leif Jansson
- Department of Periodontology, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Lundmark
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carolina Modin
- Department of Periodontology, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Denise Abadji
- Department of Periodontology, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden
| | - Tülay Yucel-Lindberg
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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40
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Hentenaar DFM, De Waal YCM, Vissink A, Van Winkelhoff AJ, Meijer HJA, Liefers SC, Kroese FGM, Raghoebar GM. Biomarker levels in peri-implant crevicular fluid of healthy implants, untreated and non-surgically treated implants with peri-implantitis. J Clin Periodontol 2021; 48:590-601. [PMID: 33454996 DOI: 10.1111/jcpe.13423] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 12/26/2020] [Accepted: 01/10/2021] [Indexed: 12/25/2022]
Abstract
AIM To compare biomarker levels in peri-implant crevicular fluid (PICF) of healthy implants with levels in PICF of implants with peri-implantitis (before and after non-surgical treatment). MATERIALS AND METHODS Samples were taken from 20 healthy implants (n = 17 patients) and from 20 implants with peri-implantitis (n = 19 patients) before and 3 months after non-surgical treatment using the Airflow Master Piezon® (EMS). A Luminex™ assay was used to evaluate pro-inflammatory and anti-inflammatory cytokines IL-1β, TNF-α, IL-6 and G-CSF, collagen degradation enzyme MMP-8, chemokines MCP-1 & MIP-1α/CCL3, bone markers OPG and sRANKL and interferon-γ. Clinical and radiographical characteristics were assessed. A Mann-Whitney U and Wilcoxon signed-rank test analysed between- and within-group differences. RESULTS IL-1β and MMP-8 levels were found significantly elevated in implants with peri-implantitis (p = .007; p = <.001, respectively). No difference in levels of TNF-α, IL-6, MCP-1 and MIP-1α/CCL3, OPG and G-CSF between healthy and diseased implants was found. Levels of sRANKL and INF-γ were under the level of detection. None of the biomarker levels improved after non-surgical therapy, and levels of IL-1β and MMP-8 remained high. CONCLUSION Implants diagnosed with peri-implantitis have higher levels of IL-1β and MMP-8 in PICF compared to healthy implants. Non-surgical therapy did not influence the inflammatory immune response.
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Affiliation(s)
- Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arie Jan Van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sylvia C Liefers
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Frans G M Kroese
- Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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41
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Sánchez-Fernández E, Magán-Fernández A, O'Valle F, Bravo M, Mesa F. Hyaluronic acid reduces inflammation and crevicular fluid IL-1β concentrations in peri-implantitis: a randomized controlled clinical trial. J Periodontal Implant Sci 2021; 51:63-74. [PMID: 33634616 PMCID: PMC7920839 DOI: 10.5051/jpis.1903660183] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/01/2020] [Accepted: 09/28/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)-1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, −1.66, −0.40 mm; control 2: 95% CI, −1.07, −0.01 mm) and 90 days (control 1: 95% CI, −1.72, −0.54 mm; control 2: 95% CI, −1.13, −0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels. Trial Registration ClinicalTrials.gov Identifier: NCT03157193
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Affiliation(s)
- Elena Sánchez-Fernández
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | | | - Francisco O'Valle
- Department of Pathology and History of Science, School of Medicine, University of Granada, Granada, Spain.,Biosanitary Research Institute (ibs.Granada), University of Granada, Granada, Spain
| | - Manuel Bravo
- Department of Preventive and Community Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Francisco Mesa
- Department of Periodontics, School of Dentistry, University of Granada, Granada, Spain
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42
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Kalsi AS, Moreno F, Petridis H. Biomarkers associated with periodontitis and peri-implantitis: a systematic review. J Periodontal Implant Sci 2021; 51:3-17. [PMID: 33634611 PMCID: PMC7920841 DOI: 10.5051/jpis.1902840142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 06/15/2020] [Accepted: 08/17/2020] [Indexed: 01/18/2023] Open
Abstract
Purpose The pathology of peri-implantitis is still not fully understood and there have been recent challenges to the consensus on its aetiology and pathology, especially in comparison with periodontitis. The assessment of biomarkers allows a comparison of the pathology of these diseases. The aim of this systematic review was to answer the research question: “Is there a difference in the biomarkers associated with peri-implantitis compared with periodontitis in adult humans?” Methods Electronic databases were searched and screened, and a manual search was also undertaken. The inclusion criteria were adults with peri-implantitis who had been compared to adults with periodontitis with the outcome of biomarkers assessed via biopsies or crevicular fluid samples in primary or secondary care settings, as recorded in case-control, case series and retrospective, prospective and cross-sectional observational studies. Two reviewers independently screened titles and abstracts and assessed full text articles for eligibility and inclusion. Both reviewers independently extracted data and assessed risk of bias. Differences in biomarker levels were the primary outcome and a narrative review was undertaken due to the heterogeneity of studies. Results In total, 2,374 articles were identified in the search, of which 111 full-text articles were assessed for eligibility and 13 were included in the qualitative synthesis. Five of the 13 included studies were deemed to be at high risk of bias, with the others having moderate risk. All studies were cross-sectional and performed at university hospitals. Nine of the 13 included studies found significant differences in the levels of biomarkers or their ratios between peri-implantitis and periodontitis. Four of the studies found no significant differences. Conclusions Within the limitations of the included studies, it appears that there may be a difference in biomarker levels and ratios between peri-implantitis and periodontitis, suggesting that these disease processes are somewhat distinct.
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Affiliation(s)
- Amardip Singh Kalsi
- Department of Restorative Dentistry, Cambridge University Hospitals, Cambridge, UK.
| | - Federico Moreno
- Unit of Periodontics, UCL Eastman Dental Institute, London, UK
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43
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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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44
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Zhou X, Wu D, Liang D, Zhang W, Shi Q, Cao Y. Evaluation of modified cold‐atmospheric pressure plasma (MCAP) for the treatment of peri‐implantitis in beagles. Oral Dis 2020; 28:495-502. [PMID: 33320400 DOI: 10.1111/odi.13757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Xincai Zhou
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Donglei Wu
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Defeng Liang
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Wenhao Zhang
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
| | - Qi Shi
- Department of Stomatology Baoan Maternal and Child Health Hospital Jinan University Shenzhen China
- Department of Stomatology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Yingguang Cao
- Department of Stomatology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
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45
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Levels of Gene Expression of Immunological Biomarkers in Peri-Implant and Periodontal Tissues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239100. [PMID: 33291232 PMCID: PMC7730812 DOI: 10.3390/ijerph17239100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023]
Abstract
This study compared the gene expression of the immunoinflammatory markers interleukin (IL)-6, IL-1ß, and tumor necrosis factor alpha (TNF-α), the matrix metalloproteinases (MMP)-1, -2, -8, and -9, and the tissue inhibitors of matrix metalloproteases (TIMP)-1 and -2 in the gingival tissue of individuals with periodontal and peri-implant disease. The study population included individuals with four periodontal statuses: periodontal health (PH group, n = 20); periodontitis (P group, n = 20); peri-implant health (PIH group, n = 20), and peri-implantitis (PI group, n = 20). Gingival biopsies were collected from one tooth per patient according to the inclusion criteria of each group. The mRNA levels of IL-6, IL-1ß, TNF-α, MMP-1, MMP-2, MMP-8, MMP-9, TIMP-1, and TIMP-2 were evaluated by qPCR. The levels of IL-1ß were significantly higher in the PI group when compared to the other groups (p < 0.05), while the levels of IL-6 were significantly higher in the groups with periodontal and peri-implant disease when compared with the healthy groups (p < 0.05); however, the levels of IL-6 did not differ between the PI and P groups (p > 0.05). For all other studied biomarkers, no significant differences were observed between groups (p > 0.05). IL-6 and IL-1ß presented higher levels of mRNA in diseased periodontal and peri-implant tissues. However, the expression of metalloproteinases and their inhibitors did not differ between the different periodontal statuses.
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46
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Narvekar A, Valverde Estepa A, Naqvi A, Nares S. Used dental implant healing abutments elicit immune responses: A comparative analysis of detoxification strategies. Clin Implant Dent Relat Res 2020; 22:730-738. [PMID: 33063441 DOI: 10.1111/cid.12956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/09/2020] [Accepted: 09/30/2020] [Indexed: 01/29/2023]
Abstract
PURPOSE To determine if healing abutments (HA) can be "decontaminated" using four strategies available in clinical settings and compare the detoxification efficacy by quantifying residual biomaterial and capacity to elicit an inflammatory response in-vitro. MATERIALS AND METHODS Forty HA collected from subjects following intraoral use were randomly distributed into four test groups (A-D): A: autoclave only, B: ultrasonic bath plus autoclave, C: prophy-jet plus autoclave, and D: Scrub sponge plus autoclave. New, sterile HA: group E (Control). Residual protein concentration was determined by Micro BCA assay and stained with Phloxine B for macroscopic examination. HA were placed in human CD14+ monocyte derived-macrophage (mo-Mφ) cultures and supernatant collected at 4, 24, 48, and 5 days to analyze cytokine profiles using multiplex bead assay. RESULTS Test groups showed visible differences in "decontamination" levels compared to control. Groups C and D showed most effective debris removal and lowest residual protein concentration. Multiplex assay showed marked induction of pro-inflammatory cytokines by groups A and B and to a significantly lower level by groups C and D. CONCLUSION HA were not entirely "decontaminated" using common methods available relative to new, sterile HA and were capable of stimulating an immune response.
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Affiliation(s)
- Aniruddh Narvekar
- Department of Periodontics, College of Dentistry, University of Illinois, Chicago, Illinois, USA
| | - Araceli Valverde Estepa
- Department of Periodontics, College of Dentistry, University of Illinois, Chicago, Illinois, USA
| | - Afsar Naqvi
- Department of Periodontics, College of Dentistry, University of Illinois, Chicago, Illinois, USA
| | - Salvador Nares
- Department of Periodontics, College of Dentistry, University of Illinois, Chicago, Illinois, USA
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47
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Kensara A, Hefni E, Williams MA, Saito H, Mongodin E, Masri R. Microbiological Profile and Human Immune Response Associated with Peri-Implantitis: A Systematic Review. J Prosthodont 2020; 30:210-234. [PMID: 33016381 DOI: 10.1111/jopr.13270] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To evaluate and synthesize the existing evidence on the microbiological and human immune response associated with peri-implantitis in comparison to healthy implants. MATERIALS AND METHODS Three electronic databases (MEDLINE, Embase, and Cochrane Library) were searched in October 2019 to identify clinical studies evaluating the microbiota and the immune response associated with peri-implantitis. Two reviewers independently screened the studies and used the full text to extract the data. A qualitative synthesis was performed on the extracted data and summary tables were prepared. Due to clinical and methodological heterogeneity among included studies, no meta-analysis was performed. RESULTS Forty studies were included in this review. Of these, 20 studies compared the microbiological profile of peri-implantitis with healthy implants. Nineteen studies focused on the immune response associated with peri-implantitis in comparison to healthy implants. Three studies focus on gene polymorphism associated with peri-implantitis. The most commonly reported bacteria associated with peri-implantitis were obligate anaerobe Gram-negative bacteria (OAGNB), asaccharolytic anaerobic Gram-positive rods (AAGPRs), and other Gram-positive species. In regard to immune response, the most frequently reported pro-inflammatory mediators associated with peri-implantitis were IL-1β, IL-6, IL-17, TNF-α. Osteolytic mediator, e.g., RANK, RANKL, Wnt5a and proteinase enzymes, MMP-2, MMP-9, and Cathepsin-K were also expressed at higher level in peri-implantitis sites compared to control. CONCLUSIONS Peri-implantitis is associated with complex and different microbiota than healthy implants including bacteria, archaea, fungi, and virus. This difference in the microbiota could provoke higher inflammatory response and osteolytic activity. All of this could contribute to the physiopathology of peri-implantitis.
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Affiliation(s)
- Anmar Kensara
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD.,Department of Restorative Dentistry, College of Dentistry, Umm Al Qura University, Makkah, Saudi Arabia.,Institute for Genome Sciences, School of Medicine, University of Maryland, Baltimore, MD
| | - Eman Hefni
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD.,Department of Basic and Clinical Oral Sciences, College of Dentistry, Umm Al Qura University, Makkah, Saudi Arabia
| | - Mary Ann Williams
- Health Sciences & Human Services Library, School of Dentistry, University of Maryland, Baltimore, MD
| | - Hanae Saito
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD
| | - Emmanuel Mongodin
- Institute for Genome Sciences, School of Medicine, University of Maryland, Baltimore, MD
| | - Radi Masri
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD
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48
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Costa RC, Souza JGS, Bertolini M, Retamal-Valdes B, Feres M, Barão VAR. Extracellular biofilm matrix leads to microbial dysbiosis and reduces biofilm susceptibility to antimicrobials on titanium biomaterial: An in vitro and in situ study. Clin Oral Implants Res 2020; 31:1173-1186. [PMID: 32894779 DOI: 10.1111/clr.13663] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/18/2020] [Accepted: 08/29/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To test the role of exopolysaccharide (EPS) polymers matrix to modulate the composition/virulence of biofilms growing on titanium (Ti) surfaces, the effect on antibiotic susceptibility, and whether a dual-targeting therapy approach for disrupted EPS matrix could improve the antimicrobial effect. MATERIALS AND METHODS A microcosm biofilm model using human saliva as inoculum was used, and the microbial composition was assessed by checkerboard DNA-DNA hybridization. EPS-enriched biofilms virulence was tested using fibroblast monolayer. Povidone-iodine (PI) was used as EPS-targeting agent followed by amoxicillin + metronidazole antibiotic to reduce bacterial biomass using an in situ model. RESULTS An EPS-enriched environment, obtained by sucrose exposure, promoted bacterial accumulation and led to a dysbiosis on biofilms, favoring the growth of Streptococcus, Fusobacterium, and Campylobacter species and even strict anaerobic species related to peri-implant infections, such as Porphyromonas gingivalis and Tannerella forsythia (~3-fold increase). EPS-enriched biofilm transitioned from a commensal aerobic to a pathogenic anaerobic profile. EPS increased biofilm virulence promoting higher host cell damage and reduced antimicrobial susceptibility, but the use of a dual-targeting approach with PI pre-treatment disrupted EPS matrix scaffold, increasing antibiotic effect on in situ biofilms. CONCLUSION Altogether, our data provide new insights of how EPS matrix creates an environment that favors putative pathogens growth and shed light to a promising approach that uses matrix disruption as initial step to potentially improve implant-related infections treatment.
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Affiliation(s)
- Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - João Gabriel Silva Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Martinna Bertolini
- School of Dental Medicine, University of Connecticut (UCONN), Farmington, CT, USA
| | - Belén Retamal-Valdes
- Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, SP, Brazil
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University (UnG), Guarulhos, SP, Brazil
| | - Valentim A R Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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Biofilm Interactions of Candida albicans and Mitis Group Streptococci in a Titanium-Mucosal Interface Model. Appl Environ Microbiol 2020; 86:AEM.02950-19. [PMID: 32111586 DOI: 10.1128/aem.02950-19] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/21/2020] [Indexed: 12/19/2022] Open
Abstract
Streptococci from the mitis group (represented mainly by Streptococcus mitis, Streptococcus oralis, Streptococcus sanguinis, and Streptococcus gordonii) form robust biofilms with Candida albicans in different experimental models. These microorganisms have been found in polymicrobial biofilms forming on titanium biomaterial surfaces in humans with peri-implant disease. The purpose of this work was to study mutualistic interactions in biofilms forming on titanium and their effect on the adjacent mucosa, using a relevant infection model. Single and mixed biofilms of C. albicans and each Streptococcus species were grown on titanium disks. Bacterial and fungal biovolume and biomass were quantified in these biofilms. Organotypic mucosal constructs were exposed to preformed titanium surface biofilms to test their effect on secretion of proinflammatory cytokines and cell damage. C. albicans promoted bacterial biofilms of all mitis Streptococcus species on titanium surfaces. This relationship was mutualistic since all bacterial species upregulated the efg1 hypha-associated gene in C. albicans Mixed biofilms caused increased tissue damage but did not increase proinflammatory cytokine responses compared to biofilms comprising Candida alone. Interestingly, spent culture medium from tissues exposed to titanium biofilms suppressed Candida growth on titanium surfaces.IMPORTANCE Our findings provide new insights into the cross-kingdom interaction between C. albicans and Streptococcus species representative of the mitis group. These microorganisms colonize titanium-based dental implant materials, but little is known about their ability to cause inflammation and damage of the adjacent mucosal tissues. Using an in vitro biomaterial-mucosal interface infection model, we showed that mixed biofilms of each species with C. albicans enhance tissue damage. One possible mechanism for this effect is the increased fungal hypha-associated virulence gene expression we observed in mixed biofilms with these species. Interestingly, we also found that the interaction of multispecies biofilms with organotypic mucosal surfaces led to the release of growth-suppressing mediators of Candida, which may represent a homeostatic defense mechanism of the oral mucosa against fungal overgrowth. Thus, our findings provide novel insights into biofilms on biomaterials that may play an important role in the pathogenesis of mucosal infections around titanium implants.
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50
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Rakic M, Monje A, Radovanovic S, Petkovic‐Curcin A, Vojvodic D, Tatic Z. Is the personalized approach the key to improve clinical diagnosis of peri‐implant conditions? The role of bone markers. J Periodontol 2020; 91:859-869. [DOI: 10.1002/jper.19-0283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/09/2019] [Accepted: 08/13/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Mia Rakic
- Institute for Biological Research “Sinisa Stankovic”University of Belgrade Belgrade Serbia
- ETEP (Etiology and Therapy of Periodontal Diseases) Research GroupUniversity Complutense of Madrid Madrid Spain
| | - Alberto Monje
- Department of PeriodontologyUniversitat Internacional de Catalunya Barcelona Spain
| | - Sandro Radovanovic
- Faculty of Organizational SciencesUniversity of Belgrade Belgrade Serbia
| | | | - Danilo Vojvodic
- Institute for Medical ResearchMilitary Medical Academy Belgrade Serbia
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