Metallothioneins in Failure of Dental Implants and Periodontitis Down Syndrome Patients.

Maria Baus-Domínguez,José-Luis Gutiérrez-Pérez,María-Angeles Serrera-Figallo,Guillermo Machuca-Portillo,Daniel Torres-Lagares,José-Cruz Ruiz-Villandiego,Raquel Gómez-Díaz,Jose-Ramón Corcuera-Flores

doi:10.3390/genes10090711

Maria Baus-Domínguez, José-Luis Gutiérrez-Pérez + Show 6 more

Open Access

https://doi.org/10.3390/genes10090711

Copy DOI

Abstract

Background: Sometimes dental implants seem to be the only therapeutic alternative for the oral rehabilitation of patients with Down syndrome, given that they usually lose all their teeth early due to suffering aggressive periodontitis and they do not usually have the skills required to wear removable prostheses. However, the evolution of dental implants in these patients shows very adverse results. It is possible that basal genetic alterations, or at least some characteristics of these, may underlie these clinical results. The metabolic pathway of metallothioneins, molecules with an important influence on bone metabolism, could be one of the said alterations. Aims: To determine whether the expression of metallothioneins (MTs) and their metabolic pathway may be identified and related to the periodontitis and lack of osseointegration of dental implants in Down syndrome patients. Materials and Methods: Retrospective study of cases and controls by comparing patients with Down syndrome, periodontal disease, and implant failure (four patients, test group) with patients with Down syndrome, without periodontal disease, and without implant failure after two years of following (seven patients, control group), by extracting peripheral blood at the time of the dental examination to extract RNA and its subsequent processing in relation to gene expression of the metabolic pathway of metallothioneins. Results: The results identified low expression in the group of patients with periodontal disease and implant failure of genes MT1E, MT1H, MT1X, MT1A, MT1B, MT1C, MT1L, MT2A, MT1M, and MT1G. Conclusions: The low MT1 and MT2 gene expression seems to be related to the onset of periodontal disease and implant rejection in Down syndrome patients, although more data are required to confirm whether this relationship is due to one of the two conditions, to both independently, or to the two jointly—this last option being indicated by our current study.

Highlights

Down syndrome (DS) covers a large number of pathologies that affect practically every system in the body, including the cardiovascular, hematological, skeletal muscle, nervous, endocrine, and digestive systems
Despite the enormous number of orofacial and dental manifestations that can be found in Down syndrome patients, the main problem that this study concentrates on arises when these patients need dental replacements or complete rehabilitation due to the loss of their teeth, or when these have never existed
Patients 9‒11 did not have implants; it was assumed, our clinical experience, that in that the in absence of periodontal disease, they becandidates candidates for from our clinical experience, the absence of periodontal disease, theywould would not not be earlyfor failure implant placement, in order to increase the number of patients in in thethe control earlyafter failure after implant placement, in order to increase the number of patients controlgroup

Summary

Introduction

Down syndrome (DS) covers a large number of pathologies that affect practically every system in the body, including the cardiovascular, hematological, skeletal muscle, nervous, endocrine, and digestive systems It affects patients’ oral health to a large extent and, determines their dental treatment. Fixed dental prostheses may be a better therapeutic option for the treatment of these patients, especially those with moderate or profound intellectual disability, since they tend to be well tolerated [2], it is important to highlight that they must be well maintained (cleaned). Aims: To determine whether the expression of metallothioneins (MTs) and their metabolic pathway may be identified and related to the periodontitis and lack of osseointegration of dental implants in Down syndrome patients. Conclusions: The low MT1 and MT2 gene expression seems to be related to the onset of periodontal disease and implant rejection in Down syndrome patients, more data are required to confirm whether this relationship is due to one of the two conditions, to both independently, or to the two jointly—this last option being indicated by our current study

Objectives

Results

Discussion

Conclusion