Abstract
ObjectiveThe objective of the study was to evaluate the relation between occlusal loading and peri-implant crevicular fluid cytokine expression in patients with implant-supported complete fixed prostheses in both arches.Material and methodsA prospective longitudinal clinical study was performed at a university clinic. Fifteen patients were selected and 11 were included. All patients had bimaxillary implant-supported complete fixed ceramo-metallic prostheses loaded at least 12 months before the beginning of the study. Allocation was established for each patient using a computerized occlusal analysis system. The test implant was the maxillary implant closest to the point of highest occlusal loading. The maxillary implant with least loading was the control implant. Occlusal adjustment was performed using a round diamond burr. This occlusal distribution was verified with the occlusal analysis system. Expression of cytokines from peri-implant crevicular fluid (TNF-α, IL-10, IL-6, IL-1β, IL-8) were recorded and analyzed in both test and control implants before (baseline: T0) and 2 (T1) and 12 months (T2) after occlusal adjustment. The Brunner-Langer non-parametric test was performed.ResultsAt T0, the expression of IL-10 was significantly higher in the test group implants (p = 0.018). Between T0 and T1, the expression of all the cytokines decreased in the implants of both groups with statistically significant differences, except for TNF (p = 0.271). When comparing both groups at T1, there was no statistically significant difference in any of the analyzed cytokines. At T2, TNF-α suffered when compared with baseline, a statistical decrease in both study and control implants (p < 0,001). At T2, there were no statistically significant differences between groups in any of the cytokines analyzed.ConclusionsImplants with higher occlusal load presented higher expression of IL-10 in peri-implant crevicular fluid. Occlusal adjustment produced a decrease in the expression of all the analyzed cytokines, both in test and control implants.
Highlights
Occlusal adjustment produced a decrease in the expression of all the analyzed cytokines, both in test and control implants
Peri-implant cytokine analysis Before occlusal adjustment (T0; baseline), test group implants expressed higher concentration of IL-6, TNF-α, and IL-10, but significant differences were only found in IL-10 (p = 0.018)
Two months after occlusal adjustment (T1), all the cytokines analyzed decreased when compared with baseline, in both test and control implants except for TNF-α that decreased without significant differences (p = 0.271)
Summary
Mechanical stress can have both positive and negative consequences for bone tissue [1] and in osseointegration [2]. Peri-implant crevicular fluid (PICF) might reflect the local peri-implant heath status [3]. Patients presenting periimplantitis usually show an increased PICF volume [4]. Levels of inflammatory mediators in PICF have been proposed as a measure of active peri-implantitis. Since this disease might be latent in its early stages, biomarker analysis in PICF might serve as a tool for early diagnosis and/ or determination of patient susceptibility [3, 5]
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