Proinflammatory cytokines (IL-1β and TNF-α) and chemokines (IL-8 and MIP-1α) as markers of peri-implant tissue condition

doi:10.1016/j.ijom.2010.01.014

International Journal of Oral and Maxillofacial Surgery

Volume 39, Issue 5, May 2010, Pages 478-485

https://doi.org/10.1016/j.ijom.2010.01.014 Get rights and content

Abstract

Analysis of peri-implant crevicular fluid (PICF) offers a non-invasive means of studying the host response in peri-implant disease and may provide an early indication of patients at risk for active disease. This study examined the PICF levels of interleukin-1beta (IL-1β), tumour necrosis factor alpha (TNF-α), interleukin-8 (IL-8) and macrophage inflammatory protein-1alpha (MIP-1α) in patients with non-manifesting inflammation, early and late stages of mucositis. The study group comprised 90 adult healthy volunteers with endosseal titanium implants inserted. Samples were taken from peri-implant sulcus using a filter paper technique. Implant tissues were categorized clinically as healthy, early mucositis or advanced mucositis. Clinical manifestations were determined by: gingival index and bleeding on probing, plaque index and radiographic analyses. Cytokine concentrations were assesed using commercially available enzyme-linked immunosorbent assay kits. Patients from the control group (healthy patients) have significantly lower concentrations of IL-1β, TNF-α, IL-8 and MIP-1α in PICF compared with both groups with mucositis. Positive correlation was noted in the control group between IL-1β and TNF-α and between MIP-1α and IL-8 in the group with early mucositis. The results suggest that cytokines could be prognostic markers of implant failure.

Section snippets

Patient selection

The study population included 90 adult healthy volunteers (nine females and 81 males), mean age 55 years, who had had at least one endosseal titanium implant with a purity level of 2/ASTM (American Society for Testing and Materials) (99.98%) and a sand-blasted, large-grit, acid (SLA) etched surface inserted. Implants were 4.5 mm in diameter, 13.5 mm long with 4 threads and were inserted into bone type II. During the study period the patients were instructed to maintain oral hygiene properly.

Concentrations according to the stage of mucositis

Concentrations of cytokines were calculated in relation to the PICF volume. Patients from the control group had significantly lower concentrations of IL-1β, TNF-α, MIP-1α and IL-8 in PICF compared with both groups with mucositis (p < 0.01 for IL-1β and p < 0.001 for TNF-α, MIP-1α and IL-8). Mean PICF values were significantly higher in the group with advanced mucositis compared with the group with early mucositis (Table 2, Table 3).

Concentrations according to PI values

The patients with a PI value of 0 had significantly lower

Discussion

Oral rehabilitation can be optimized using endosteal implants to enhance prosthetic replacement of the dentition¹⁰. Peri-implant disease may have a multifactorial background where an aberrant host response in conjuction with the bacterial challenge may contribute to the development of tissue destruction around implants. Clarification of factors of importance for peri-implant disease may make it easier to predict which implant is at risk for peri-implant complications. The thickness and quality

Funding

None.

Competing interests

Authors have no financial or personal relationships with other people or organisations that inappropriately influences their actions.

Ethical approval

Ethical approval for the examination was given by Ethical Committee of Military/Medical Academy in Belgrade, Serbia.

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Citation Excerpt :
A clinical study conducted by Severino et al. confirmed that the levels of the IL family (IL-6, IL-10, IL-17 and IL-33) in PICF are significantly higher in PIM and PI patients [27]. The study conducted by Petković et al. support that the PICF MIP-1α, IL-1β and TNF-α levels in PIM patients are remarkably enhanced, when compared to those in healthy subjects, and that cytokines may be a prognostic biomarker for the dental implant [28]. Jiang et al. reported that the levels of the SERPINs family in PICF are overexpressed in PI patients, and that the serine protease inhibitors family play an important role in the pathogenesis of PI [29].
A dental Implant is a prosthetic device made of alloplastic materials implanted into the bone to provide retention and support for a dental prosthesis. Sirtuin1 (SIRT1) molecule, a nicotinamide adenine dinucleotide (NAD)-dependent histone deacetylase, regulates a variety of physiological and pathological processes, including oxidative stress, metabolism, cell proliferation, cell differentiation, inflammatory, and apoptosis. We explored whether the expression of SIRT1 correlates in patients receiving implants with peri-implant mucositis (PIM) and peri-implantitis (PI) in comparison to patients with healthy peri-implant area (PIH).
A number of 198 patients with dentition defects were enrolled in the study after their implants were functional for at least 6 months. All 198 subjects were divided into 3 groups: 1) control patients with PIH healthy implants; 2) patients with PIM mucositis; and 3) patients with PI implantitis. To distinguish these three groups, peri-implant crevicular fluid (PICF) was collected by inserting a sterile paper strip into the gap around the implant and the levels of SIRT1 and cytokines were measured by the enzyme linked immunosorbent assay (ELISA). Demographic and clinical data included age, sex, Body Mass Index (BMI), probing depth (PD), plaque index (PLI), bleeding on probing (BOP), oral health impact profile (OHIP-14), history of periodontitis and the use time of implants.
The PD, PLI, OHIP-14 evaluation scores in patients with periodontitis of PIM mucositis and PI implantitis were all significantly higher than in patients with PIH healthy implants. Overall, the SIRT1 levels in PICF of the PIM and PI patients were significantly lower than of the PIH patients. In comparison with PIM patients, SIRT1 levels of the PI patients were remarkably lower than the PIH patients. Pearson's analysis showed that SIRT1 levels were negatively correlated with levels of interleukin (IL)-6, C-reactive protein (CRP) and IL-1β in patients with PIM and PI. We suggest that SIRT1 levels could serve as a potential diagnostic biomarker of PI or PIM. The PICF levels of SIRT1, CRP, IL-6, IL-1β and the history of periodontitis were the risk factors for patients with peri-implant inflammatory process.
The measurement of SIRT1 expression in PICF may serve as a biomarker for the ongoing inflammatory process in patients with dental implants. The low SIRT1 levels correlated with PI implantitis and PIM mucositis as well as the elevated levels of pro-inflammatory cytokines (CRP, IL-6 and IL-1β).
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Alveolar ridge regularization involves the smoothing and minimal reduction of rough alveolar bone ridge to achieve adequate bone thickness around the implant. The effect of this procedure on peri-implant health is unclear.
The purpose of this clinical study was to evaluate whether bone regularization affects the clinical and biological parameters of peri-implant health when narrow diameter implants are placed as mandibular implant overdenture retainers during initial healing and after occlusal loading.
The need for mandibular ridge regularization in the anterior mandibular region was analyzed before the placement of 2 implants (2.9×10 mm, Facility; Neodent) in 21 participants provided with mandibular overdentures. Primary stability was measured by the insertion torque and implant stability quotient (ISQ). Clinical and biological evaluations measuring the plaque index, presence of calculus, probing depth, bleeding on probing index, gingival index, secondary stability (ISQ), and interleukine-1β (IL-1β) and tumor necrosis factor-α (TNF-α) concentrations in peri-implant crevicular fluid were measured during osseointegration on days 7, 15, 30, 60, and 90 and after loading on day 180 after implant placement. Multilevel mixed-effects linear regression analysis and the Kaplan–Meier test were used to analyze the data (α=.05).
The ISQ values showed significant differences on days 7 (P<.001) and 15 (P=.002) with higher values and on day 180 (P=.008) with a lower value compared with the baseline value in the ridge regularization group. Additionally, a significant decrease in probing depth was observed on days 60 (P=.008) and 180 (P=.027) compared with that on day 15 after implant placement. In the nonridge regularization group, significant decreases in probing depth were observed on days 30 and 180. Moreover, TNF-α levels in this group were significantly lower on days 30 (P=.001), 60, 90, and 180 (P<.001) when compared with the value on day 7 (P<.001). The ridge regularization group presented with significant differences in TNF-α and IL-1β levels on days 60 (P=.004) and 30 (P=.007), respectively, when compared with the values on day 7. The ISQ and probing depth in the ridge regularization group were associated with changes in TNF-α and IL-1β levels; furthermore, bone type, duration of edentulism, and mandibular bone atrophy were correlated with the clinical outcomes and TNF-α release. The implant survival rate was 67% in the nonridge regularization group and 100% in the ridge regularization group.
Mandibular ridge regularization appeared to be beneficial for peri-implant healing during the early stages and after 3 months of occlusal loading in patients with an atrophic ridge, prolonged time since edentulism, and poor bone quality.
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Research PaperDental ImplantsProinflammatory cytokines (IL-1β and TNF-α) and chemokines (IL-8 and MIP-1α) as markers of peri-implant tissue condition

Abstract

Section snippets

Patient selection

Concentrations according to the stage of mucositis

Concentrations according to PI values

Discussion

Funding

Competing interests

Ethical approval

Int J Oral Maxilofac Surg

Cytokine

Detection of prostaglandin E2 and matriks metalloproteinases in implant crevicular fluid

Int J Oral Maxillofac Implants

Soft tissue response to plaque formation at different implant systems. A comparative study on the dog

Clin Oral Implants Res

Interleukin 1β, tumor necrosis factor α levels and neutrophil elastase activity in peri-implant crevicular fluid

Clin Oral Implants Res

Mucositis and Peri-implantitis. Clinical Periodontology and Implant Dentistry

Crevicular fluid analysis around two failing dental implants: a clinical report

J Prosthodont

The acute inflammatory response and the role of phagocytic cells in periodontal health and disease

Periodontol 2000

The protective nature of host responses in periodontal disease

Periodontol 2000

Different types of inflammatory reactions in peri-implant soft tissues

J Clin Periodontol

Chemokines in human periodontal disease tissues

Clin Exp Immunol

Microbiological findings and host response in patients with peri-implantitis

Clin Oral Implants Res

Increased interleukin-1 beta in the crevicular fluid of diseased implants

Int J Oral Maxillofac Implants

Diagnosis of periodontal disease based on analysis of the host response

Periodontol 2000

Research Paper
Dental Implants
Proinflammatory cytokines (IL-1β and TNF-α) and chemokines (IL-8 and MIP-1α) as markers of peri-implant tissue condition