Abstract
BackgroundDue to the world-wide increase in treatments involving implant placement, the incidence of peri-implant disease is increasing. Late implant failure is the result of the inability to maintain osseointegration, whose most important cause is peri-implantitis. The aim of this study was to analyze the clinical, microbiological, and immunological aspects in the peri-implant sulcus fluid (PISF) of patients with healthy dental implants and patients with peri-implantitis.MethodsPISF samples were obtained from 24 peri-implantitis sites and 54 healthy peri-implant sites in this prospective cross-sectional study. The clinical parameters recorded were: modified gingival index (mGI), modified plaque index (mPI) and probing pocket depth (PPD). The periodontopathogenic bacteria Tannerella forsythia, Treponema denticola and Porphyromonas gingivalis were evaluated, together with the total bacterial load (TBL). PISF samples were analyzed for the quantification of Interleukin (IL)-8, IL-1β, IL-6, IL-10 and Tumor Necrosis Factor (TNF)-α using flow cytometry (FACS).ResultsThe mGI and PPD scores in the peri-implantitis group were significantly higher than the healthy group (p < 0.001). A total of 61.5% of the patients with peri-implantitis had both arches rehabilitated, compared with 22.7% of patients with healthy peri-implant tissues; there was no implant with peri-implantitis in cases that received mandibular treatment exclusively (p < 0.05). Concentrations of Porphyromonas gingivalis (p < 0.01), association with bacteria Porphyromonas gingivalis and Treponema denticola (p < 0.05), as well as the TBL (p < 0.05) are significantly higher in the peri-implantitis group. IL-1β (p < 0.01), IL-6 (p < 0.01), IL-10 (p < 0.05) and TNF-α (p < 0.01) are significantly higher at the sites with peri-implantitis compared to healthy peri-implant tissue, while IL-8 did not increase significantly.ConclusionThe results of the present study involving a limited patient sample suggest that the peri-implant microbiota and which dental arch was rehabilitated involved could contribute to bone loss in peri-implantitis. A significant relationship is observed between the concentration of cytokines (interleukins 1β, 6 and 10 and TNF-α) and the inflammatory response in peri-implantitis tissue.
Highlights
Due to the world-wide increase in treatments involving implant placement, the incidence of peri-implant disease is increasing
The aim of this study was to study the clinical characteristics of peri-implantitis as established by the modified plaque index, modified gingival index and probe depth, examines the microbial and host response Interleukin (IL)-8, IL-1β, IL-6, IL-10 and Tumor Necrosis Factor (TNF)-α characteristics in dental implants with periimplantitis, and establishes comparisons with healthy dental implants
There were no statistically significant differences in the percentage of sites at which plaque was found between the groups. modified gingival index (mGI) scores were significantly higher around implants with peri-implantitis than around healthy implants (p < 0.001)
Summary
Due to the world-wide increase in treatments involving implant placement, the incidence of peri-implant disease is increasing. Using the checkerboard DNA-DNA hybridization method, Socransky et al [13] identified a consortium of the bacterial species Tannerella forsythia (T. forsythia), Treponema denticola (T. denticola) and Porphyromonas gingivalis (P. gingivalis) as having the highest association with periodontal disease severity. The authors named this microbial consortium “red complex”. Evaluation of the literature has shown the microbiota associated to peri-implantitis to be more complex than that found under healthy peri-implant conditions – the main flora consisting of anaerobic gram-negative bacteria [14]. In healthy peri-implant sulci, oral streptococci constitute the predominant bacterial flora [15]
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