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


CONCLUSIONS
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.
Duarte
Poliana Mendes
PM
Department of Periodontics, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil. pduarte@ung.br
de Mendonça
Adriana Cutrim
AC
Máximo
Maria Beatriz Braz
MB
Santos
Vanessa Renata
VR
Bastos
Marta Ferreira
MF
Nociti
Francisco Humberto
FH
D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D016022:Case-Control Studies; D002710:Chlorhexidine / Q000627:therapeutic use; D016207:Cytokines / Q000032:analysis*; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D015921:Dental Implants / Q000009:adverse effects*; D003774:Dental Plaque Index; D012534:Dental Scaling; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D006801:Humans; D007378:Interleukins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D052016:Mucositis / Q000209:etiology / Q000276:immunology / Q000628:therapy; D053244:Osteoprotegerin / Q000032:analysis; D010512:Periodontal Index; D010518:Periodontitis / Q000209:etiology / Q000276:immunology* / Q000628:therapy*; D053245:RANK Ligand / Q000032:analysis; D013280:Stomatitis / Q000209:etiology / Q000276:immunology* / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000891:Anti-Infective Agents, Local; D016207:Cytokines; D015921:Dental Implants; D007378:Interleukins; D009067:Mouthwashes; D053244:Osteoprotegerin; D053245:RANK Ligand; D014409:Tumor Necrosis Factor-alpha; D002710:Chlorhexidine