Effects of customized CAD/CAM abutments on cytokine levels in peri-implant crevicular fluid during early implant healing: a pilot study

Clin Oral Investig. 2023 Jun;27(6):2621-2628. doi: 10.1007/s00784-022-04826-x. Epub 2022 Dec 24.

Abstract

Objectives: This study aimed to assess levels of biomarkers associated with inflammation and tissue destruction in peri-implant crevicular fluid (PICF) of implants provided with customized or standard healing abutments during early implant healing.

Materials and methods: Thirty implants were placed in 22 patients with partial posterior edentulism. Subsequently, test group implants (n=15) received one-piece titanium abutments that were fabricated using computer-aided design/computer-aided manufacturing (CAD/CAM). Control group implants (n=15) were provided with standard abutments. PICF collection and standardized periapical radiographs were carried out at suture removal one week later, following crown delivery after 3 months and at 6 months. Expression of C-reactive protein (CRP), interferon-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12A, IL-17A, macrophage inflammatory protein (MIP)-1α, matrix metalloproteinase (MMP)-13, osteopontin, osteoactivin, Receptor Activator of NF-κB (RANK), and TGF-β were analyzed using a multiplex ELISA kit.

Results: Both groups showed a significant decrease in protein expression of CRP, IL-1β, IL-6, IL-8, MIP-1α, osteopontin, osteoactivin, and TGF-β, while MMP-13 levels increased during the observation period. A rise in OPG and RANK levels was detected among customized abutments. Expression of CRP was higher, whereas IL-1β, IL-1α, and MIP-1α were decreased in control compared to test group implants after 6 months. Marginal bone loss did not depend on abutment modality.

Conclusions: Both abutment types showed distinctive temporal expression of inflammatory biomarkers during 6 months following implant placement.

Trial registration: ISRCTN98477184, registration date 18/05/2022 CLINICAL RELEVANCE: Customized healing abutments exert similar effects on inflammation during early implant healing compared to standard healing abutments.

Keywords: Bone implant interface; Cytokines; Dental implant-abutment design; Osseointegration.

MeSH terms

  • Chemokine CCL3
  • Computer-Aided Design
  • Dental Abutments
  • Dental Implants*
  • Humans
  • Inflammation
  • Interleukin-1alpha
  • Interleukin-6
  • Interleukin-8
  • Osteopontin
  • Pilot Projects
  • Titanium
  • Transforming Growth Factor beta
  • Tumor Necrosis Factor-alpha / analysis

Substances

  • Dental Implants
  • Chemokine CCL3
  • Osteopontin
  • Interleukin-6
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • Interleukin-1alpha
  • Transforming Growth Factor beta
  • Titanium