Effect of anti-infective mechanical therapy on clinical parameters and cytokine levels in human peri-implant diseases

J Periodontol. 2009 Feb;80(2):234-43. doi: 10.1902/jop.2009.070672.

Abstract

Background: The objectives of this study were to clinically and immunologically assess the effects of mechanical anti-infective therapies for mucositis and peri-implantitis and to compare the levels of cytokines in untreated and treated peri-implant diseased sites to healthy ones.

Methods: Titanium dental implants were assigned to one of the following groups: healthy (n = 10) = control; mucositis (n = 10) = mechanical debridement using abrasive sodium carbonate air-powder and resin curets; and peri-implantitis (n = 20) = open surgical debridement using abrasive sodium carbonate air-powder and resin curets. Visible plaque accumulation, marginal bleeding, bleeding on probing, suppuration, and probing depth were assessed at baseline for all groups and at 3 months after therapies for diseased groups. At these times, the total amounts of interleukin (IL)-4, -10, and -12, tumor necrosis factor-alpha (TNF-alpha), receptor activator of nuclear factor-kappa B ligand (RANKL), and osteoprotegerin (OPG) in the peri-implant crevicular fluid (PICF) were measured by enzyme-linked immunosorbent assay.

Results: At 3 months, the anti-infective treatments resulted in a significant improvement in all clinical parameters for mucositis and peri-implantitis (P <0.05). Moreover, the total amounts of TNF-alpha in PICF were significantly higher in untreated diseased implants compared to healthy ones, and the OPG/RANKL ratio was higher for healthy implants than for untreated peri-implantitis (P <0.05). TNF-alpha levels were significantly reduced for both diseased groups (P <0.05), achieving the same level as the healthy group at 3 months after therapies (P >0.05).

Conclusion: The proposed anti-infective therapies may locally modulate the levels of TNF-alpha and the OPG/RANKL ratio and improve clinical parameters around peri-implant tissues.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents, Local / therapeutic use
  • Case-Control Studies
  • Chlorhexidine / therapeutic use
  • Cytokines / analysis*
  • Dental Implantation, Endosseous / adverse effects
  • Dental Implants / adverse effects*
  • Dental Plaque Index
  • Dental Scaling
  • Female
  • Gingival Crevicular Fluid / chemistry*
  • Humans
  • Interleukins / analysis
  • Male
  • Middle Aged
  • Mouthwashes / therapeutic use
  • Mucositis / etiology
  • Mucositis / immunology
  • Mucositis / therapy
  • Osteoprotegerin / analysis
  • Periodontal Index
  • Periodontitis / etiology
  • Periodontitis / immunology*
  • Periodontitis / therapy*
  • RANK Ligand / analysis
  • Stomatitis / etiology
  • Stomatitis / immunology*
  • Stomatitis / therapy*
  • Tumor Necrosis Factor-alpha / analysis

Substances

  • Anti-Infective Agents, Local
  • Cytokines
  • Dental Implants
  • Interleukins
  • Mouthwashes
  • Osteoprotegerin
  • RANK Ligand
  • Tumor Necrosis Factor-alpha
  • Chlorhexidine