Characterization of the antioxidant profile of human saliva in peri-implant health and disease

OBJECTIVES: Peri-implant disease is considered to be an inflammatory disease, but many aspects of its pathogenesis remain unknown. At present, peri-implant disease is considered to be initiated and perpetuated by a small group of predominantly Gram-negative, anaerobic, or micro-aerophilic bacteria that colonize the subgingival area. Bacteria cause the observed tissue destruction directly by toxic products and indirectly by activating host defence systems, i.e. inflammation. A variety of molecular species appears in the inflamed tissues, among them are reactive species such as free radicals and reactive oxygen species (ROS). The purpose of this study was to assess levels of various antioxidants in saliva to identify differences between the saliva of patients with healthy peri-implant tissues and patients with peri-implant disease, and to examine whether the whole saliva of those with peri-implant disease conditions might have lower levels of antioxidants than that of healthy individuals. MATERIALS AND METHODS: Thirty healthy adult volunteers (14 men and 16 women) with implant-supported overdentures (Ankylos Biofunctional Implants) were selected from the group of patients from Tallinn Dental Clinic. Biochemical and clinical parameters evaluated were the following ones: the levels of urate, ascorbate, myeloperoxidase in saliva, total antioxidant status of saliva, pocket probing depth (mm), gingival index (0, 1, 2, or 3), and bleeding on probing (0 or 1). RESULTS AND CONCLUSION: Total antioxidant status (TAS) of saliva and concentration of uric acid and ascorbate, which are the main salivary antioxidants, are significantly decreased in patients with peri-implant disease. TAS in healthy subjects was 0.41+/-0.10 for resting saliva and 0.31+/-0.09 for stimulated saliva; in diseased subjects TAS was 0.19+/-0.07 and 0.12+/-0.03, respectively. In healthy subjects, the concentration of urate was 307.2+/-78.06 microM/l in resting saliva and 241.5+/-89.09 microM/l in stimulated saliva. In diseased patients, the concentration of urate was 120+/-36.13 and 91.60+/-39.35 microM/l, respectively. The concentration of ascorbate did not differ in resting and stimulated saliva. In healthy subjects, it was 2.79+/-0.81 mg/l and in diseased subjects, it was 1.54+/-0.30 mg/l. This may indicate that excessive ROS production in peri-implant disease is leading to the situation of excessive oxidative stress, which may be an important factor contributing the destruction of peri-implant tissues. The importance of these findings may be the better understanding of the processes involved in the pathogenesis of peri-implant disease and that the treatment of peri-implant disease may involve adjuvant anti-oxidants supplementation together with cumulative interceptive supportive therapy concept introduced by Mombelli & Lang.     

Expression of IL-6, IL-10, IL-17 and IL-33 in the peri-implant crevicular fluid of patients with peri-implant mucositis and peri-implantitis

ObjectivesThe aim of this study was to compare the levels of IL-6, IL-10, IL-17 and IL-33 in the peri-implantar crevicular fluid (PICF) and in parotid gland saliva (PGS) of healthy patients, and peri-implantitis and peri-implant mucositis patients.Materials and methodsThe PICF was collected from 40 implants as follows: 10 peri-implant mucositis patients, 20 peri-implantitis patients and 10 healthy patients. The PICF and PGS samples collected from each patient were quantified for IL-6, IL-10, IL-17 and IL-33 by enzymatic immunosorbent assay (ELISA).ResultsIL-6, IL-17 and IL-33 levels on PIFC were significantly higher in peri-implantitis group when compared to healthy group. IL-17 and IL-33 levels in PIFC were significantly higher in peri-implant mucositis group than in healthy group. There was no significant difference when comparing IL-6, IL-10, IL-17 and IL-33 levels in PGS among healthy, peri-implant mucositis and peri-implantitis groups.ConclusionsTherefore, as in patients with peri-implantitis there were significantly higher levels of IL-6, IL-17 and IL-33 in PICF, we believe that these cytokines were intensifying local inflammatory process, and contributing to clinical aspects such as increased marginal bleeding and probing depth found in patients with peri-implantitis. Furthermore, as IL-17 and IL-33 were increased in patients with peri-implant mucositis, hypothesized that these cytokines were also contributing to the inflammatory process observed in this disease.     

A comparison of implant-supported, bar- or ball-retained mandibular overdentures: a retrospective clinical, microbiologic, and immunologic study of 10 edentulous patients attending a recall visit

PURPOSE: Clinical, microbiologic, and immunologic comparisons of the peri-implant health in edentulous volunteers wearing long-standing implant-supported ball- or Dolder bar-retained mandibular overdentures were performed. MATERIALS AND METHODS: Ten age- and gender-matched individuals (mean age, 71 years) with either ball- or bar-retained complete mandibular overdentures, scheduled for an annual implant recall examination, were investigated an average of 7 years after implant placement. Plaque and gingival crevicular fluid samples were obtained from the peri-implant sulcus. The groups were compared with regard to peri-implant probing depth; plaque and bleeding on probing scores; sulcular fluid flow rates; implant stability measurements (Periotest device); relative concentrations of Actinobacillus actinomycetemcomitans, Prevotella intermedia, Fusobacterium nucleatum, Porphyromonas gingivalis, Tannerella forsythensis, and Treponema denticola assessed by polymerase chain reaction analysis; and sulcular concentrations of interleukin-1beta and prostaglandin E2, assessed by enzyme-linked immunosorbent assay. RESULTS: No statistically significant differences were found for any of the examined parameters between both study groups. CONCLUSION: Within the limitations of this study, both ball attachments and Dolder bars can be recommended for overdenture retention, with either one showing satisfying clinical, microbiologic, and immunologic findings in the peri-implant tissues after several years of service in healthy recall patients with good oral hygiene habits.     

Correlation between salivary IL-1beta levels and periodontal clinical status

OBJECTIVE: To assess the concentration of the proinflammatory cytokine IL-1beta in saliva of periodontally diseased and healthy patients and their relationship with the periodontal status. DESIGN: Unstimulated whole saliva samples from patients with chronic periodontitis (n=30), aggressive periodontitis (n=18) and healthy controls (n=18) were obtained for the study. The periodontal status of each subject was assessed by criteria based on probing depth, clinical attachment loss and the extent/severity of periodontal breakdown. The levels of IL-1beta were measured in saliva samples with a high sensitivity enzyme-linked immunosorbent assay (ELISA). RESULTS: Although no significant difference (P=0.624) was found for salivary IL-1beta levels between periodontitis groups, they were significantly greater (P<0.01) than those detected for healthy controls. Furthermore, Spearman correlation analysis showed statistically significant correlations (P<0.01) between data from salivary IL-1beta levels and clinical measurements. CONCLUSION: The findings of the present study reemphasize the importance of whole saliva as sampling method in terms of immunological purposes in periodontal disease and suggest that the elevated IL-1beta concentration may be one of the host-response components associated to the clinical manifestations of periodontal disease.     

Influence of patient age on the success rate of dental implants supporting an overdenture in an edentulous mandible: a 3-year prospective study

The aim of this study was to determine the influence of age on peri-implant tissues in patients treated with implant-supported overdentures in the mandible. A prospective study was carried out with 2 groups of healthy edentulous patients. The mean age of the younger group (n = 32) was 46 years (range 35 to 50 years); the mean age of the older group (n = 26) was 68 years (range 60 to 80 years). Two dental implants were placed in the interforaminal region of the mandible, and after a 3-month healing period, overdentures were fabricated. Clinical and radiographic parameters were evaluated immediately after completion of the prosthetic treatment, after 1 year, and after 3 years. The evaluated clinical parameters were implant loss, Plaque Index, Gingival Index, Bleeding Index, and probing depth. Radiographic evaluation was performed using a standardized long-cone technique with a direction device. Statistical analysis was carried out with SPSS software. One implant in the older group was lost during the healing period. After 3 years, the mean scores for Plaque Index, Gingival Index, and Bleeding Index were between 0 and 1 for both groups (out of possible scores of 0 to 3), and the mean probing depth was 3 mm in both groups. The mean bone loss after 3 years was 1.2 mm in the younger group and 0.8 mm in the older group, but this difference was not significant. It was concluded from this study population that the clinical performance of implant-supported overdentures in the mandible is equally successful in younger and older patients.     

Peri-implant diseases: diagnosis and risk indicators

Background: Peri-implant diseases include peri-implant mucositis, describing an inflammatory lesion of the peri-implant mucosa, and peri-implantitis, which also includes loss of supporting bone.
Methods: A literature search of the Medline database (Ovid), up to 21 January 2008 was carried out using a systematic approach, in order to review the evidence for diagnosis and the risk indicators for peri-implant diseases.
Results: Experimental and clinical studies have identified various diagnostic criteria including probing parameters, radiographic assessment and peri-implant crevicular fluid and saliva analyses. Cross-sectional analyses have investigated potential risk indicators for peri-implant disease including poor oral hygiene, smoking, history of periodontitis, diabetes, genetic traits, alcohol consumption and implant surface. There is evidence that probing using a light force (0.25 N) does not damage the peri-implant tissues and that bleeding on probing (BOP) indicates presence of inflammation in the peri-implant mucosa. The probing depth, the presence of BOP, and suppuration should be assessed regularly for the diagnosis of peri-implant diseases. Radiographs are required to evaluate supporting bone levels around implants. The review identified strong evidence that poor oral hygiene, a history of periodontitis and cigarette smoking, are risk indicators for peri-implant disease. Future prospective studies are required to confirm these factors as true risk factors.     

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

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.     

Interleukin-1β and Interleukin-6 Expression and Gene Polymorphisms in Subjects with Peri-Implant Disease

Background: Polymorphisms found in the IL-1 family genes have been associated with susceptibility of periodontal disease. However, very little is known about the relationship between polymorphisms on inflammatory mediators' genes and peri-implant disease. Purpose: The aim of the present study was to evaluate interleukin-1β (IL-1β) and interleukin-6 (IL-6) concentration in the crevicular fluid, and the impact of gene polymorphisms on healthy and diseased implants in comparison with healthy teeth. Materials and Methods: We examined 47 implants and teeth in 47 patients grouped as: 31 healthy implants, 16 implants with peri-implantitis, 31 healthy teeth from patients with healthy implants, and 16 healthy teeth from patients with peri-implantitis. Clinical parameters were recorded from all implants and teeth. Gingival crevicular fluid was collected to evaluate the concentration of IL-1β and IL-6. Cells from buccal mucosa were collected and their genomic DNA extracted for identification of the following polymorphisms: IL1B+3954, IL1B-511, and IL6-174. Results: Clinical evaluation demonstrated that implants with peri-implantitis had less favorable indexes for probing depth (PD), relative clinical attachment level (CAL), bleeding on probing, and suppuration when compared with healthy implants and, for PD and CAL when compared with healthy teeth. There was no significant difference in the concentration of IL-1β and IL-6 detected between groups. There were no statistically significant differences between alleles and polymorphisms distribution on the studied population. Conclusions: There was no correlation between the concentration of IL-1β and IL-6 in the crevicular sulcular fluid present in healthy or diseased osseointegrated implants in comparison with healthy teeth. The studied gene polymorphisms had no influence on peri-implant disease.     

种植体周围龈沟液中骨桥蛋白水平与种植体周围炎关系的研究

目的探讨种植体周围龈沟液中骨桥蛋白(OPN)水平与种植体周围炎的关系。方法选择山西医科大学第一附属医院口腔科接受牙种植术戴冠后12个月的患者30例(40枚种植体),按照临床指标标准分为炎症种植体组[探诊深度(PD)>3 mm、牙龈出血指数(SBI)>2 mm,28枚种植体]和健康种植体组(PD≤3 mm、SBI≤2,12枚种植体);同时选择患者同名健康牙(40颗)为对照组。检查并记录所有患者PD、SBI;检测龈沟液量及其中OPN质量浓度(ABC-ELISA法)。结果 (1)炎症种植体组的PD值、SBI值、龈沟液量、OPN质量浓度均高于对照组和健康种植体组(均P<0.05);对照组和健康种植体组间各指标差异无统计学意义(均P>0.05)。(2)种植体周围龈沟液中OPN质量浓度同各临床指标间均呈正相关关系。结论种植体龈沟液中OPN质量浓度可在一定程度上反映种植体周围组织的健康状态。     

Levels of interleukin-1 beta, -8, and -10 and RANTES in gingival crevicular fluid and cell populations in adult periodontitis patients and the effect of periodontal treatment

BACKGROUND: Various cytokines have been identified at sites of chronic inflammation such as periodontitis. Cytokines are synthesized in response to bacteria and their products, inducing and maintaining an inflammatory response in the periodontium. The purpose of the present study was to investigate the involvement of interleukin-1 beta (IL-1 beta), IL-8, and IL-10 and RANTES (regulated on activation, normally T cell expressed and secreted) and the cell populations associated with the immune response in destructive periodontitis, as well as the effect of periodontal therapy on cytokine levels in gingival crevicular fluid (GCF). METHODS: Data were obtained from 12 patients with moderate to advanced periodontitis and 6 healthy controls. Patients presenting at least 2 sites with > or =2 mm clinical attachment loss were included in the destructive periodontitis group. After monitoring for 4 months, only 6 patients showed destructive periodontitis and GCF samples and soft tissues biopsies were collected from these patients. GCF samples and biopsies were collected both from active (12 CGF samples and 6 biopsies) and inactive (12 CGF samples and 6 biopsies) sites. The comparison with healthy controls was carried out by collecting GCF samples from 6 healthy volunteers (12 samples) and biopsies during the surgical removal of wisdom teeth. In periodontal patients, clinical data and GCF samples were obtained prior to periodontal treatment (72 samples) and 2 months after periodontal therapy (72 samples). GCF was collected using a paper strip; eluted and enzyme-linked immunoabsorbent assays (ELISA) were performed to determine cytokine levels. The inflammatory infiltrate was analyzed by immunohistochemistry of gingival biopsy samples with monoclonal antibodies against CD3, CD8, CD4, CD11c, and CD19 antigens. RESULTS: Cellular components of the inflammatory infiltrate include B and T lymphocytes and monocyte/macrophages. Active sites contained a higher number of B lymphocytes and macrophages. IL-8 and IL-1 beta and RANTES in GCF were detected in the majority of sites from periodontal patients (100%, 94% and 87%, respectively); IL-10 was found in only 43%. IL-8 was the only cytokine detected in the GCF (75%) of the control group. Moreover, IL-1 beta levels were significantly higher in active sites versus inactive sites (P <0.05). IL-8 and IL-10 and RANTES were increased in active sites; however, differences were not significant (P>0.05). A positive correlation between the IL-8 and RANTES (r = 0.677, P<0.05) was observed in periodontitis patients. Periodontal therapy reduced the total amount of IL-1 beta, IL-8, and IL-10 and RANTES. Data showed a weak correlation between the clinical parameters and the total amount of cytokines in periodontitis. CONCLUSIONS: These data suggest that the amount of crevicular IL-1 beta, IL-8, and IL-10 and RANTES is associated with periodontal status. Removal of the bacterial plaque reduces the antigenic stimuli and consequently could modulate the chemokines present in GCF. We propose that the dynamic interactions between cytokines, their production rates, and their quantity could represent factors controlling the induction, perpetuation, and collapse of the cytokine network present in the periodontal disease.     

实验性种植体周围炎龈沟液中IL-10和IL-17的分析

目的：分析实验性种植体周围炎不同时期龈沟液（PISF）中IL-10和IL-17的变化,探讨其在种植体周围炎发生发展过程中的作用。方法：采用丝线结扎法建立狗的实验性种植体周围炎模型,种植体随机分为实验组A（丝线持续结扎17w）和实验组B（结扎8w后去除丝线并进行洁治）,以口腔内另一侧不进行丝线结扎的种植体为对照。各组种植体分别在丝线结扎时（基点）和基点后1、4、8、9、13、17周时记录牙周袋深度（PPD）、菌斑指数（PI）和改良龈沟出血指数（MBI）,采集种植体周围龈沟液,检测PISF的量以及其中IL-10和IL-17的含量。分析不同时间点和不同组别种植体各项临床指标、PISF量以及其中IL-10和IL-17的差异。结果：与对照组相比,丝线结扎后种植体周围PPD、PI和MBI均出现改变。在临床指标出现改变前,PISF的量以及其中IL-10和IL-17的含量开始变化。PISF的量随时间增加,8周后保持比较稳定的水平,洁治后PISF量降低,13周后与对照组无差异。IL-10的含量随时间降低,8周后保持比较稳定的水平,洁治后开始升高。IL-17的含量随时间增加,洁治后降低。结论：IL-10和IL-17与种植体周围炎的发生发展有密切关系,其含量可在一定程度上反映种植体周围组织的炎症状况,IL-17可能作为早期诊断和预测种植体周围炎的指标。     

Correlation of peri-implant health and myeloperoxidase levels: a cross-sectional clinical study

OBJECTIVES: At present, there are no diagnostic tools that permit early detection of peri-implantitis. The purpose of this cross-sectional study was to evaluate the correlation of myeloperoxidase (MPO) levels with traditional periodontal clinical parameters around dental implants including peri-implant pocket probing depth (PPD), gingival index (GI) and bleeding on probing (BOP), since MPO has been associated with destruction of periodontal tissues. MATERIAL AND METHODS: Twenty-four healthy adult volunteers (9 men and 15 women) with 64 Ankylos Biofunctional implants (DentsplyFriadent, Mannheim, Germany) were recruited from Tallinn Dental Clinic. Biochemical and clinical parameters evaluated were the following ones: the level of MPO in the peri-implant sulcus fluid (PISF) (an analog for gingival crevicular fluid in natural teeth), PPD (mm), GI (0,1,2 or 3), and BOP (0 or 1). RESULTS AND CONCLUSION: In comparison to the clinically healthy implants, total amounts of MPO were significantly higher in PISF collected around implants with inflammatory lesions. In addition, the levels of MPO were correlated with the clinical parameters. The results confirm the similarity of the inflammatory response of tissues surrounding implants and natural teeth, and suggest that MPO could be promising marker of inflammation around dental implants.     

To splint or not to splint oral implants in the implant‐supported overdenture therapy? A systematic literature review

The objective of this systematic review was to assess the influence of splinted and unsplinted oral implants in the mandibular and maxillary implant-supported overdenture therapy, concerning the implant survival, the peri-implant parameters, the prosthetic complications and the patient satisfaction. An electronic MEDLINE search complemented by manual searching was conducted to identify randomized clinical trials, prospective and retrospective cohort studies on implant-supported overdentures with a mean follow-up of at least 3 years. Twelve studies from an initial yield of 1022 titles were finally selected and data were extracted. After an observation period of more than 3 years, there was no difference in implant survival rates between splinted and unsplinted design. From most of the investigations included in this study, it was mentioned that the unsplinted design needs more prosthetic maintenance. In more of the studies that were dealing with the satisfaction of the patients wearing implant-supported overdentures, no significant difference in the preference of the patients was reported. No significant difference in the peri-implant outcome between splinted and unsplinted design was found. Within the limits of this systematic review, it is concluded that there was no significant difference between the two different designs of implant-supported overdentures with respect to the soft tissue health status or patient satisfaction, although the bar-supported overdentures have been shown to need less prosthetic maintenance.     

Serum cytokine levels and periodontal parameters in ankylosing spondylitis

Sezer U, Erciyas K, Pehlivan Y, Üstün K, Tarakç?o?lu M, ?enyurt SZ, Onat AM. Serum cytokine levels and periodontal parameters in ankylosing spondylitis. J Periodont Res 2012; 47: 396–401. © 2011 John Wiley & Sons A/S Background and Objective: Multiple studies support the role of periodontal disease in contributing to the chronic systemic inflammatory burden in a variety of diseases, including ankylosing spondylitis (AS), in the progression which the inflammatory process plays an important role. We assume that patients with AS are more likely to have periodontal disease than healthy individuals. The aim of this study was to determine the possible relationship between inflammatory periodontal diseases and AS by evaluating clinical periodontal parameters and serum cytokine levels. Material and Methods: Forty‐eight adults with AS (35 women and 13 men; age range 18–56 years; mean age 34.27 years) and 48 age‐ and sex‐matched systemically healthy control subjects participated in the study. The clinical periodontal parameters, venous blood and Bath Ankylosing Spondylitis Disease Activity Score were obtained, and serum C‐reactive protein, tumour necrosis factor‐α and interleukin‐6 (IL‐6) levels were evaluated. Results: There was statistically no significant difference in the frequency of periodontitis between AS patients and the control group. Furthermore, there was no significant difference in probing depth, clinical attachment level and plaque index, and the only significant clinical difference between groups was in levels of bleeding on probing (p < 0.001). Serum concentrations of IL‐6, tumour necrosis factor‐α and C‐reactive protein in the AS group were significantly higher than those in the control group (p < 0.001). In the AS group, there was a correlation between serum IL‐6 levels and clinical attachment level (p < 0.001). Conclusion: The results of present study suggest that bleeding on probing was the only different periodontal parameter between the AS and the control group, and the periodontal status of patients with AS may be affected by IL‐6 levels.     

Implant-supported maxillary overdentures retained with milled bars: maxillary anterior versus maxillary posterior concept--a retrospective study

PURPOSE: The aim of the present retrospective investigation was to evaluate implant-supported maxillary overdentures using either anterior (group 1) or posterior (group 2) maxillary implant placement. MATERIAL AND METHODS: Maxillary overdentures were planned with support by either 4 implants placed in the maxillary anterior region (group 1) or 6 to 8 implants placed in augmented maxillary posterior regions (group 2, bilateral sinus augmentation) and anchored either on an anterior or on 2 bilaterally placed milled bars. Cumulative implant survival rate, peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index, and Calculus Index) and the incidence and type of prosthodontic maintenance were assessed and compared for the 2 groups. In addition, the cumulative survival rate for implants placed in grafted regions was compared with that of implants placed in nongrafted regions. RESULTS: Thirty-four patients (16 for group 1 and 18 for group 2) with 179 implants were available for follow-up examination after a mean period of 42.1 +/- 20.1 months. Four initially placed implants failed to osseointegrate and were replaced, but no further losses were seen during the loading period, for a 5-year cumulative implant survival rate of 978%. No differences in implant survival rates were seen between either the group-1 (98.4%) and group-2 (97.4%) concepts or nongrafted (98.0%) and grafted (97.5%) implants. The peri-implant parameters showed a healthy soft tissue, good oral hygiene, and an acceptable degree of peri-implant marginal bone loss. The rigid fixation of all overdentures was associated with a low incidence of prosthodontic maintenance, without any significant differences between the 2 groups. CONCLUSIONS: In well-planned overdenture treatment programs, a high survival rate and excellent peri-implant conditions can be achieved for implants placed in the anterior or posterior maxilla. Rigid anchorage of maxillary overdentures either on an extended anterior milled bar or on 2 bilateral posterior milled bars provides for a low incidence of prosthodontic maintenance.     

母体唾液及龈沟液细胞因子水平与早产低体重新生儿关系的病例对照研究

目的 验证牙周炎是否为早产低体重新生儿(preterm low birth weight,PLBW)母亲体内低度炎症的来源之一,初步探讨PLBW与炎症因子之间的关系.方法 以83例PLBW的母亲(PLBW组)及44名健康新生儿(normal birth weight,NBW)的母亲(NBW组)为研究对象,留取受试对象的静息全唾液、龈沟液,应用酶联免疫吸附试验检测唾液和龈沟液中白细胞介素(IL)-1β和IL-6水平,比较两组间唾液和龈沟液中细胞因子水平的差异,并分析细胞因子与分娩孕周、新生儿体重之间的相关性.结果 唾液IL-1β水平在PLBW组[(78.32±11.81)ng/L]显著高于NBW组[(39.66±11.89)ng/L],差异有统计学意义(P<0.05);分娩孕周与唾液IL-6之间呈显著的负相关关系(r=-0.274,P<0.01);新生儿体重与龈沟液IL-1β(r=-0.231,P<0.01)、唾液IL-6(r=-0.424,P<0.01)之间呈显著的负相关关系.结论 唾液和龈沟液中炎性因子水平越高,分娩孕周越短、新生儿体重越轻,母体牙周炎程度与PLBW之间可能存在一定程度的相关关系.     

Effect of non-surgical periodontal therapy on C-telopeptide pyridinoline cross-links (ICTP) and interleukin-1 levels

BACKGROUND: Biochemical markers harvested from gingival crevicular fluid (GCF) may be useful to identify and predict periodontal disease progression and to monitor the response to treatment. C-telopeptide pyridinoline cross-links (ICTP), a host-derived breakdown product specific for bone, and interleukin-1beta (IL-1), a potent bone-resorptive cytokine, have been associated with periodontal tissue destruction. The aim of this study was to examine the effect of non-surgical periodontal therapy on GCF levels of ICTP and IL-1. METHODS: Twenty-five chronic periodontitis subjects were monitored at 8 sites per subject at baseline prior to scaling and root planing and 1, 3, and 6 months after therapy. Four shallow (probing depths < 4 mm) and 4 deep (probing depths > or = 5 mm) sites were monitored for both marker levels and clinical parameters. GCF was collected for 30 seconds on paper strips, and levels of ICTP and IL-1 were determined using radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) techniques, respectively. Clinical measurements included probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). RESULTS: Deep sites exhibited significantly (P<0.001) higher ICTP and IL-1 levels compared to shallow sites at all time intervals. ICTP demonstrated a stronger association to clinical parameters than IL-1 including a modest correlation (r = 0.40, P<0.001) between ICTP and attachment loss. Significant improvements in PD, CAL, and BOP were observed at 1, 3, and 6 months in all sites (P<0.01). However, non-surgical mechanical therapy did not significantly reduce ICTP and IL-1 levels over the 6-month period. Further examination of subjects based on smoking status revealed that ICTP levels were significantly reduced at 3 and 6 months and IL-1 levels reduced at 3 months among non-smokers only. CONCLUSIONS: A single episode of non-surgical mechanical therapy did not significantly reduce biochemical markers associated with bone resorption in patients exhibiting chronic periodontitis. Future longitudinal studies are warranted to specifically evaluate the relationship between C-telopeptide pyridinoline cross-links and periodontal disease progression.     

Cytokine profiles in parotid saliva from HIV-1-infected individuals: changes associated with opportunistic infections in the oral cavity

The purpose of this study was to quantitate levels of cytokines in parotid saliva of subjects infected with human immunodeficiency virus-1 (HIV-1) and to determine if the cytokine profiles differ in subjects with an oral opportunistic infection, i.e., candidiasis or oral hairy leukoplakia. Parotid saliva samples were obtained from HIV-infected individuals with or without candidiasis or oral hairy leukoplakia and from healthy controls and were assessed by ELISA for levels of interleukin (IL)-1, IL-2, IL-4, IL-5, IL-10, transforming growth factor-beta, tumor necrosis factor-alpha and interferon (IFN)-gamma. Saliva from HIV-infected subjects with oral candidiasis had significantly higher levels of IFN-gamma than that seen in HIV-infected individuals with no oral disease and significantly higher levels of IL-2, IL-5 and IFN-gamma than saliva of healthy controls. No significant difference was seen in cytokine levels in saliva from HIV-infected subjects with no oral infections and healthy controls. The HIV-infected subjects with oral hairy leukoplakia displayed significantly higher levels of both IL-1 alpha and IFN-gamma compared with the HIV and no oral disease group and a higher level of IFN-gamma than seen in saliva from the healthy control group. In comparing cytokine levels from both HIV and oral disease groups, significant differences were detected in levels of IL-5 and IL-10. These results indicate that the profile of salivary cytokines is altered as a result of the oral opportunistic infection candidiasis or oral hairy leukoplakia and also by concurrent HIV infection.     

Comparison of two different techniques used for the maintenance of peri-implant soft tissue health: a pilot randomized clinical trial

Objectives: The aim of this pilot study was to compare the effectiveness of two different methods of debridement on maintaining and improving peri-implant soft tissue health over a period of 12 months.

Materials and methods: Twenty adult patients (25 implants) were enrolled in a randomized, single-blinded, parallel group clinical trial. All implants included showed no signs of pathologic bone loss. Patients were scheduled to be reviewed every 3 months over a 12 months period. Nine patients (15 implants) were randomly allocated to a test group and treated with a low abrasive air polishing powder (Air-Flow^® Perio, EMS) (AFP) and another nine (10 implants) to a control group and treated with titanium curettes (TC). Peri-implant crevicular fluid samples were analyzed to quantitatively measure the concentration of six interleukins (IL-6, IL-8, IL-1β, TNF, IL-10 and IL-12). A multilevel analysis was used to test the comparison between the two treatments. The same analysis was used to study the relationship between clinical parameters and cytokines while controlling for confounding factors.

Results: There was no significant difference in bleeding on probing (BOP) between the two treatment methods (p?=?.35). Both debridement techniques resulted in a similar reduction of BOP (40.04% and 39.93%). IL-6 was the only cytokine of the six investigated that demonstrated a correlation with a clinical parameter (BOP) (p?=?.05).

Conclusions: Both treatment methods were proven to be effective in reducing peri-implant inflammation and preventing further disease progression. Some cytokines may act as markers for peri-implant disease as the present study showed a significant relationship between IL-6 and BOP.     

Effects of enamel matrix derivative on non-surgical management of peri-implant mucositis: a double-blind randomized clinical trial

Background

Peri-implant diseases have been recognized as being among the ever-increasing complications related to dental implants. The aim of this study was to evaluate the adjunctive use of enamel matrix derivative (EMD) to mechanical debridement (MD) in patients with these conditions in terms of clinical parameters and cytokine levels of peri-implant crevicular fluid (PICF).

Methods

In the present double-blind clinical trial, 46 patients with peri-implant mucositis (PM) were randomly divided into control and test groups. Two different therapeutic protocols, consisting of non-surgical MD alone (control group) and MD with the application of EMD (test group), were considered for the two groups. Clinical parameters [bleeding on probing (BOP) and probing depth (PD)] and sampling from PICF were carried out before treatment and 3 months postoperatively. The levels of IL-6 and IL-17 cytokines in PICF were evaluated by enzyme-linked immunosorbent (ELISA).

Results

Three-month post-interventional assay revealed significant improvements in BOP and PD in the test group in comparison to the control group (P < 0.0001). Relative to control, IL-6 and IL-17 levels were reduced significantly (p < 0.05) in the test group compared to the control group.

Conclusion

Application of EMD can be considered an adjunct to MD in the non-surgical treatment of PM. However, complete recovery was not observed using either treatment approach showing that management of implant-associated disease is still a significant clinical problem.