Peri-implantitis Patients Research Articles

Cytokines expression in saliva and peri‐implant crevicular fluid of patients with peri‐implant disease

This study aimed to measure the levels of GM-CSF, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IFN-γ and TNF-α in peri-implant crevicular fluid (PICF) and saliva from patients with peri-implant disease. Twenty two total edentulous patients were divided into two groups: Mucositis (MU) patients with bone loss around the implants until the first thread and pocket depth ≤3 mm, and Peri-implantitis (PI) patients with at least one implant with bone loss around two or more threads and pocket depth ≥4 mm. The clinical parameters evaluated were probing pocket depth, bleeding on probing, and percentage of plaque. PICF samples were collected from MU sites, and from shallow (SPI) and deep (DPI) sites in PI. Unstimulated whole and parotid duct saliva was collected from all patients. The cytokines were measured by a multiplexed immunoassay. PI patients had a higher percentage of plaque compared with MU (P = 0.02). MU sites had lower pocket depth compared to SPI (P = 0.001) and to DPI (P ≤ 0.001). In PICF, the levels of IL-1β were significantly higher in SPI sites compared to MU (P = 0.03). In the saliva from parotid, IL-8 and IL-12 were significantly higher in patients with PI (P = 0.04). Elevated levels of IL-1β in PICF seem to be a characteristic trait of patients with peri-implantitis. The parotid duct saliva showed a significant increase in expression of IL-8, which might be related to a systemic response.

Expression of IL-22, IL-22R and IL-23 in the peri-implant soft tissues of patients with peri-implantitis

ObjectivesThe aim of this study was to compare the expression of interleukin (IL)-22, IL-22R and IL-23 in the peri-implant soft tissues between the peri-implantitis patient group (PG) and peri-implant healthy control group (HG). MethodsThe tissues were collected from 12 peri-implantitis patients and eight peri-implant healthy controls. Immunohistochemistry (IHC) and real-time quantitative PCR (qPCR) were performed to analyse the gene expression of IL-22, IL-22R and IL-23p19 in peri-implant soft tissues in the PG and the HG group. ResultsThe IHC result showed that number of IL-22, IL-22R, and IL-23p19 positive cells increased in PG than in HG (P<0.05). The result of qPCR demonstrated that the expressions of IL-22 messenger RNA (mRNA) and IL-23p19 mRNA were significantly higher in the PG group compared to the HG group (P<0.05). Gene expression of IL-22R mRNA was higher in the PG group; however, there was no statistically significant difference between these two groups (P>0.05). ConclusionsThis study indicates that there is an increased expression level of IL-22 and IL-23 in patients with peri-implantitis, which may induce expression of related pro-inflammatory cytokines and may further have a crucial role in tissue repair and reconstruction in pathogenesis of peri-implantitis.

Peri‐Implantitis versus Periodontitis: Functional Differences Indicated by Transcriptome Profiling

Periodontitis and Periimplantitis are oftentimes discussed as one entity, which is reflected by therapeutical as well as by scientific approaches. It is unclear, to which extent the similarity of the clinical characteristics is attributed to similarities in the underlying disease mechanisms. The main objective of the study is to display if or how different periimplantitis and periodontitis are on the mRNA level, representing a high-resolution map of disease-associated events. Aiming to describe the pathophysiological mechanisms in vivo, primary gingival tissue from 7 periimplantitis patients, 7 periodontitis patients and 8 healthy controls was employed in order to generate genome wide transcriptome profiles. On the basis of quantitative transcriptome analysis, we could show that periimplantitis and periodontitis exhibit significantly different mRNA signatures. Additionally we present a disease associated mRNA profile, which displays potential periimplantitis disease mechanisms. A gene ontology analysis revealed various pathways, supporting the hypothesis of periimplantitis being a complex inflammatory disorder with a unique pathophysiology. While in periimplantitis tissue the regulation of transcripts related to innate immune responses and defense responses were dominating, in periodontitis tissues bacterial response systems prevailed. Taken together, our results suggest considering periimplantitis and periodontitis as disease entities with shared as well as with distinct features, which should be reflected on the therapeutical as well as on the scientific level.

Prevalence and risk factors for peri‐implant disease in Belgian adults

This study aimed to evaluate in a Belgian population the frequence of mucositis and peri-implantitis in patients with implants of at least 5 years of function. Another outcome was to access implants/patients characteristics as possible risk indicators for peri-implantitis. One hundred and three patients (38 males/65 females) with a total of 266 implants were examined. Implants had been inserted in university hospitals as well as in private clinics and the mean time of implants in function was 8.5years (±3.2). The average patients' age within the population was 62years (±13.4). General health informations were recorded as well as habits regarding smoking, maintenance visits and oral hygiene. Full mouth clinical parameters (PlI, BoP, PPD) were assessed and radiographs taken to determine the periodontal status and implants diagnosis. Prevalences of mucositis and peri-implantitis at the patient's level were respectively 31% and 37%. They were 38% and 23% at the implant's level. Subjects older than 65years (OR = 1.39) and those with active periodontitis (OR = 1.98) were prone to peri-implantitis. The association was stronger for hepatitis (OR = 2.92) and totally edentulous patients (OR = 5.56). Finally, at the implant's level, a significant correlation was found in the multi-level analyses between rough surfaces, overdentures and peri-implantitis. After 8.5years an important proportion (±60%) of implants presented biological complications. Furthermore, a positive correlation was showed between age, periodontitis, absence of teeth, rough surfaces and peri-implantitis. Consequently, patients with such characteristics should be informed before implant placement and frequently re-called after for maintenance visits.

Residual periodontal pockets are a risk indicator for peri-implantitis in patients treated for periodontitis

Does the data support the conclusion that 'the maintenance of periodontal health, rather than the previous history of periodontitis, is the critical determinant of increased risk of peri-implant disease'?

Development and evaluation of new primers for PCR-based identification of type IIfimAofPorphyromonas gingivalis

For more accurate PCR-based identification of Porphyromonas gingivalis harboring genotype II fimA, the most prevalent type in periodontitis patients, a new primer set was developed and evaluated. The previous type II primers hybridized to the DNA of P gingivalis strains harboring type Ib as well as type II fimA, while the new primers specifically amplified only the DNA fragment of type II fimA. In the investigation using mixed bacterial culture and 155 clinical samples from peri-implantitis patients, the new primers increased the accuracy of PCR-based detection of type II fimA by excluding false-negatives as well as false-positives.

Comparison of IKKI Gene Polymorphisms (rs1539243 and rs12728136) between Chronic Periodontitis and Peri-implantitis Patients in an Iranian Population (A Cross-Sectional Study)

In the present study, we sought to assess the correlation of IKKi gene polymorphisms (rs1539243 and rs12728136) with chronic periodontitis and peri-implantitis in an Iranian population for the first time in dentistry. This cross-sectional study was conducted on 75 patients with chronic periodontitis, 38 patients with peri-implantitis, and 84 periodontally healthy subjects. Blood samples were taken from all subjects (5 cc venous) and transferred into Falcon tubes containing EDTA. Extracted DNA samples were evaluated with a spectrophotometer (75 ng), transferred into a 96-well plate, and sent to KBioscience Institute in the United Kingdom for analysis. Assessment of IKKi gene polymorphisms was performed at the KBioscience Institute. Data were analyzed using SPSS v19 software. Differences in genotype frequencies and allele among patients and controls were evaluated using the chi-squared test (P<0.05). A significant difference was detected between the peri-implantitis and chronic periodontitis groups in distribution of CC, TC, and TT genotypes in rs1539243 (P<0.05). Statistically significant differences were detected among the three groups in the frequency of T and C alleles for rs1539243 (P=0.03). Within the limitations of the present study, the results showed a significant difference in IKKi gene polymorphism rs1539243 between the peri-implantitis and chronic periodontitis groups. However, such difference was not observed in rs12728136 between the two groups.

TRAF Family Member-Associated NF-KB Activator (TANK) Gene Polymorphism in Chronic Periodontitis and Peri-implantitis Patients

This study sought to determine TANK (rs1921310, rs3820998) gene polymorphism in patients suffering from chronic periodontitis and peri-implantitis among an Iranian population. In this cross-sectional study, 77 chronic periodontitis and 40 peri-implantitis patients, along with 89 periodontally healthy subjects, were evaluated. A 5 cc venous blood sample was obtained from subjects. DNA was extracted using Miller's salting-out method and polymorphisms were determined by the use of KBioscience's Competitive Allele-Specific PCR (CASP) genotyping system. Data were analyzed using SPSS version 11.5 software. Differences in allele and genotype frequencies among patients and controls were evaluated with Kruskal-Wallis test. P<0.05 was considered statistically significant. No significant differences were detected between understudy groups in distribution of CC and CA genotypes and alleles when evaluating rs3820998 polymorphism or in distribution of GA and AG genotypes and alleles when assessing rs1921310 polymorphism. Within the limitations of this study, it seems that these two polymorphisms do not play a significant role in pathogenesis of chronic periodontitis or peri-implantitis among the Iranian population. However, we recommend performing similar studies with larger sample sizes among the Iranian population and other communities.

O.157 Multi modal cell analysis for detection of oral cancer

The aim of this randomized placebo-controlled clinical study was to investigate the effects of a probiotic tablet containing Lactobacillus reuteri in peri-implantitis patients.Subjects comprised 30 patients with mild to moderate peri-implantitis. A baseline clinical examination and microbiological assessment were conducted, followed by an antibiotics treatment (azithromycin, 500 mg, once a day for 3 days). Subjects were divided into probiotic and placebo groups. The clinical examination and bacterial sampling were performed 0, 4, 12 and 24 weeks after the intake of probiotics. The clinical examination included probing pocket depth (PPD), bleeding on probing (BOP), the modified plaque index (mPI), and modified bleeding index (mBI). The number of bacteria was assessed using the PCR-invader method. The Wilcoxon rank-sum test and Wilcoxon signed-rank test with Bonferroni corrections were used for data analyses.Although the number of bacteria decreased after the administration of azithromycin in both groups, they increased again thereafter. No significant difference was observed in bacterial numbers between the two groups. Although PPD in the probiotics group was significantly lower at 4 and 24 weeks than at 0 weeks (p < 0.05), a significant decrease did not occur in the placebo group. The mBI score at 24 weeks was significantly lower in the probiotics group than in the placebo group (p < 0.05). No significant difference was observed in BOP or mPI between the two groups.These results suggested that probiotics prevent inflammation by affecting host responses rather than improving microbial flora in peri-implant sulci in peri-implantitis patients.

Characteristics of collagenase-2 from gingival crevicular fluid and peri-implant sulcular fluid in periodontitis and peri-implantitis patients: pilot study

Objective. To compare collagenase activity and collagenolytic matrix metalloproteinase (MMP) levels in gingival crevicular fluid (GCF) and in peri-implant sulcular fluid (PISF) in gingivitis (G), chronic periodontitis (CP), and peri-implantitis (PI) human subjects. Material and Methods. GCF and PISF were collected on filter paper strips, volume was determined, and samples were extracted in buffer containing general proteinase but not MMP inhibitors. Collagenase activity was measured using a DNP-synthetic octapeptide, and molecular and activation forms of collagenase-2 by Western immunoblotting. Results. GCF from CP and G sites exhibited elevated collagenase activity and flow, but collagenase concentrations expressed per µl were not significantly different between the healthy and G sites. Minimal fluid was obtained from healthy PISF, and collagenase concentration was the same or lower than in healthy GCF. Although PISF flow was 34% lower than GCF flow in CP subjects, collagenase concentration in CP and in PI sites was 78% and 971% greater, respectively, than in the appropriate healthy sites. Western immunoblot revealed MMP-8 in both PISF and GCF; fibroblast-type MMP-8 was not detected in healthy GCF and PISF. Immunoreactivity level and inactive and activated forms of PMN-type MMP-8 in GCF and PISF increased with the severity of periodontitis and peri-implantitis. Enhanced levels of fibroblast-type MMP-8 in active form were detected only in severe CP GCF and PI PISF. Conclusions. Peri-implantitis PISF contained higher collagenase-2 levels and activity than GCF from similar deep CP sites. GCF and PISF from severe CP and PI exhibited the highest activation of MMP-8 isoenzymes species (PMN and fibroblast-type).

IL‐1RN gene polymorphism is associated with peri‐implantitis

Interleukin (IL)-1alpha, IL-1beta and their natural specific inhibitor IL-1 receptor antagonist (IL-1ra) play a key role in the regulation of the inflammatory response in periodontal tissues. Polymorphisms in the IL-1 gene cluster have been associated with severe adult periodontitis. We aimed to investigate the IL-1 gene cluster polymorphisms in patients with peri-implantitis. The study included 120 North Caucasian individuals. A total of 71 patients (mean age 68 years, 76% smokers) demonstrating peri-implantitis at one or more implants as evidenced by bleeding and/or pus on probing and bone loss amounting to >3 threads on Brånemark implants and 49 controls (mean age 66 years, 45% smokers) with clinical healthy mucosa and no bone loss around the implants were recruited for the study. The titanium implants, ad modum Brånemark, had been in function for at least 2 years. Mouthwash samples were collected and used for genotyping of the bi-allelic polymorphisms IL-1A(-889), IL-1B(+3953), IL-1B(-511) and a variable number of tandem repeat IL-1RN gene polymorphisms using PCR technique. Significant differences were found in the carriage rate of allele 2 in the IL-1RN gene between peri-implantitis patients and controls (56.5% vs. 33.3%, respectively; odds ratios (OR) 2.6; 95% confidence interval (CI) 1.2-5.6; P=0.015). Logistic regression analysis taking smoking, gender and age into account confirmed the association between the IL-1RN allele 2 carriers and peri-implantitis (OR 3; 95% CI 1.2-7.6; P=0.02). Our results provide evidence that IL-1RN gene polymorphism is associated with peri-implantitis and may represent a risk factor for this disease.

Osteocalcin, deoxypyridinoline and interleukin-1beta in peri-implant crevicular fluid of patients with peri-implantitis.

The aim of the present study was to analyze the levels of osteocalcin, deoxypyridinoline (Dpd) and interleukin-1beta as markers of bone metabolism in peri-implant crevicular fluid (PICF) from peri-implantitis patients. PICF was sampled from a total of 34 endosseous titanium implants from 16 patients; nine females (mean age 52.8, range 40-62 years) and seven males (mean age 56.0, range 36-66 years). The implants had been in place for a period of 9-112 months (mean; 35.8 months) since the loading. These sites were categorized as six peri-implantitis, eight peri-implant mucositis and 20 healthy implant. PICF volume from peri-implantitis sites was significantly higher than mucositis and healthy implant sites (P < 0.01). Osteocalcin levels in PICF from mucositis sites were significantly higher than healthy implants (P < 0.05), whereas peri-implantitis sites were not significantly different from either mucositis or healthy implant sites. Dpd could not be detected in any of the samples examined. IL-1beta levels in PICF from peri-implantitis sites were significantly higher than levels from peri-implant mucositis (P < 0.05) and healthy implant sites (P < 0.01). In conclusion, osteocalcin in PICF may reflect increased local bone turnover around implants. Further, IL-1beta should be a useful marker for peri-implant inflammation.