title: Comparison of peri-implant crevicular fluid levels of adrenomedullin and human beta defensins 1 and 2 from mandibular implants with different implant stability quotient levels in nonsmoker patients.
abstract: OBJECTIVE
  To achieve satisfactory osseointegration, primary stability and healthy peri-implant tissue must be available. In this study, our objective was to compare the adrenomedullin, human beta-defensin (hBD)-1 and hBD-2 levels in implants with different implant stability quotient (ISQ) values and with different peri-implant tissue health values in the peri-implant crevicular fluid.
  
  
  METHODS
  Thirty patients with 60 endosseous osseointegrated implants were included in this study. Following the completion of the osseointegration process, these implants were divided into two main groups: a group of 15 implants with peri-implantitis (peri-implantitis: 40 ≤ ISQ ≤ 80 peri-implantitis, n = 15) and a group of 45 implants with healthy peri-implant tissue. The healthy peri-implant tissue group was further divided into three subgroups according to their ISQ values (Healthy-60: 60 ≤ ISQ ≤ 70, healthy peri-implant, n = 15; Healthy-80: 71 ≤ ISQ ≤ 80, healthy peri-implant, n = 15; and Healthy-100: 81 ≤ ISQ ≤ 100, healthy peri-implant, n = 15). The levels of adrenomedullin, hBD-1 and hBD-2 in the peri-implant crevicular fluid were assessed using ELISAs.
  
  
  RESULTS
  When the peri-implant clinical measurements were compared within groups, they were found to be highest in the peri-implantitis group and lowest in the Healthy-100 group. The adrenomedullin, hBD-1 and hBD-2 levels in the peri-implant crevicular fluid of the peri-implantitis group were found to be significantly higher than those in the Healthy-60, Healthy-80 and Healthy-100 groups. When only the healthy peri-implant tissue groups were evaluated, the adrenomedullin, hBD-1 and hBD-2 levels in the peri-implant crevicular fluid of the Healthy-60 group were found to be significantly higher than those in the Healthy-80 and Healthy-100 groups. The lowest adrenomedullin, hBD-1 and hBD-2 levels were observed in the Healthy-100 group.
  
  
  CONCLUSIONS
  In cases of peri-implantitis, higher adrenomedullin, hBD-1 and hBD-2 levels were observed. These results indicate the presence of a tissue response to prevent the creation of a pathological environment in the peri-implant tissue. In groups with healthy peri-implant tissues, the ISQ value decreases as the adrenomedullin, hBD-1 and hBD-2 levels increase. This condition is thought to be caused by increased dental plaque accumulation and bone resorption in addition to increased lateral implant movements and colonization of microorganisms in the microcavities between the implant elements.
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Yuzuncu Yil University, Van, Turkey.
authors.forename: A S
authors.initials: AS
authors.lastname: Ertugrul
authors.forename: Y
authors.initials: Y
authors.lastname: Tekin
authors.forename: N Z
authors.initials: NZ
authors.lastname: Alpaslan
authors.forename: A
authors.initials: A
authors.lastname: Bozoglan
authors.forename: H
authors.initials: H
authors.lastname: Sahin
authors.forename: A
authors.initials: A
authors.lastname: Dikilitas
mesh_terms: D053607:Adrenomedullin / Q000032:analysis*; D000328:Adult; D016301:Alveolar Bone Loss / Q000378:metabolism; D023181:Antimicrobial Cationic Peptides / Q000032:analysis; D015921:Dental Implants; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D005891:Gingivitis / Q000378:metabolism; D006801:Humans; D008297:Male; D008334:Mandible / Q000502:physiology; D016348:Osseointegration / Q000502:physiology*; D057873:Peri-Implantitis / Q000378:metabolism; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000378:metabolism; D023083:beta-Defensins / Q000032:analysis*
chemical_list: D023181:Antimicrobial Cationic Peptides; C406407:DEFB1 protein, human; C106641:DEFB4A protein, human; D015921:Dental Implants; D023083:beta-Defensins; D053607:Adrenomedullin
keywords: adrenomedullin; dental implant; human beta defensin 1; human beta defensin 2; implant stability quotient