Abstract
ObjectivesThe aim of this study was to compare the expression of host-derived markers in peri-implant/gingival crevicular fluid (PCF/GCF) and clinical conditions at ceramic implants and contralateral natural teeth. As a secondary objective, we compared zirconia implants with titanium implants.MethodsOne zirconia implant (ZERAMEX® Implant System) and one contralateral natural tooth were examined in 36 systemically healthy subjects (21 males, 15 females, mean age 58). The levels of Il-1β, Il-1RA, Il-6, Il-8, Il-17, b-FGF, G-CSF, GM-CSF, IFNɣ, MIP-1β, TNF-α, and VEGF were assessed in PCF/GCF using the Bio-Plex 200 Suspension Array System. The plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing (BOP) were assessed at six sites around each implant or tooth. Titanium implants were also assessed when present (n = 9).ResultsThe zirconia implants were examined after a loading period of at least 1.2 years (average 2.2 years). The mean PI was significantly lower at zirconia implants compared to teeth (p = 0.003), while the mean GI, PD, and BOP were significantly higher (p < 0.001). A correlation was found in the expression of Il-1RA, Il-8, G-CSF, MIP-1β, and TNF-α at zirconia implants and teeth. The levels of IL-1β and TNF-α were significantly higher at zirconia implants than at teeth. No significant differences were found between zirconia and titanium implants. A correlation was found between the levels of IL-1RA, IL-8, GM-CSF, and MIP-1β at zirconia and titanium implants.ConclusionsThe correlation in the expression of five biomarkers at zirconia implants and teeth, and of four biomarkers at zirconia and titanium implants, is compatible with the existence of a patient-specific inflammatory response pattern. Higher mean GI, PD, and BOP around implants suggests that the peri-implant mucosa may be mechanically more fragile than the gingiva.Clinical relevanceSimilar expression of selected biomarkers at zirconia implants and teeth and at zirconia and titanium implants reflects existence of patient-specific inflammatory response patterns.
Highlights
The prevalence of peri-implantitis at titanium implants is estimated in the order of 10 % implants and 20 % patients during 5 to 10 years after implant placement [1]
Higher mean gingival index (GI), probing depth (PD), and bleeding on probing (BOP) around implants suggests that the peri-implant mucosa may be mechanically more fragile than the gingiva
One zirconia implant with an all-ceramic crown and one contralateral natural tooth were examined in 36 subjects, 21(58 %) male and 15(42 %) female, with a mean age of 54.3 ± 12.5 years
Summary
The prevalence of peri-implantitis at titanium implants is estimated in the order of 10 % implants and 20 % patients during 5 to 10 years after implant placement [1]. Some authors have suggested adverse immune reactions to titanium oxide as a possible contributing factor to biological complications [2, 3]. To what extent peri-implant infections could be lowered by choosing another implant material is unknown. Zirconia ceramics have been proposed as an alternative. Favorable physical and chemical properties [4], color adaptability, claims of high biocompatibility [5], and low affinity to plaque [6] have made zirconium dioxide (ZrO2) a material of particular interest. The available evidence for specific benefits of dental zirconia implants is incomplete. The number of clinical studies is limited and their results are rather inhomogeneous [7]
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