title: Can peri-implant crevicular fluid assist in the diagnosis of peri-implantitis? A systematic review and meta-analysis.
abstract: BACKGROUND
  A broader understanding of the immune inflammatory profile of peri-implant diseases could be helpful in the development of host-targeted preventive and therapeutic strategies. The aim of this study is to answer two clinical questions: 1) whether patients with peri-implantitis (PP) present higher prevalence of any specific inflammatory cytokine in peri-implant crevicular fluid (PICF) compared with healthy patients; and 2) whether local inflammation measured in PICF can be used as a predictor for incipient PP.
  
  
  METHODS
  A systematic review of the literature on the most common cytokines released in PICF in healthy and PP-affected sites was conducted from 1996 up to and including October 2013 using predefined search strategies. Cross-sectional and prospective longitudinal studies were considered. Meta-analyses were done separately for healthy, mucositis (MU), and PP outcomes.
  
  
  RESULTS
  Interleukin (IL)-1β was the most studied cytokine (n = 12), followed by tumor necrosis factor (TNF)-α (n = 10). Other cytokines were also linked to PP, such as IL-4, IL-6, IL-8, IL-10, IL-12, and IL-17. Statistical differences were revealed when IL-1β release was compared between healthy implant sites and PP (P = 0.001) or MU sites (P = 0.002), respectively; when PP and MU were compared, no statistical differences could be detected (P = 0.80). For TNF-α release, significant differences were found between healthy and PP implants (P = 0.02).
  
  
  CONCLUSIONS
  PICF containing inflammatory mediators, such as IL-1β and TNF-α, can be used as additional criteria for a more robust diagnosis of peri-implant infection. Additionally, once the inflammatory process is installed, no differences were found between peri-implant MU and PP.
authors: Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
authors: Fernanda
authors: F
authors: Faot
authors: Gustavo G
authors: GG
authors: Nascimento
authors: Amália M
authors: AM
authors: Bielemann
authors: Thiago D
authors: TD
authors: Campão
authors: Fábio R M
authors: FR
authors: Leite
authors: Marc
authors: M
authors: Quirynen
mesh_terms: D015415:Biomarkers / Q000032:analysis; D016207:Cytokines / Q000032:analysis*; D015921:Dental Implants; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D007378:Interleukins / Q000032:analysis; D057873:Peri-Implantitis / Q000175:diagnosis*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D015415:Biomarkers; D016207:Cytokines; D015921:Dental Implants; D018836:Inflammation Mediators; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha
keywords: Diagnosis; inflammation; interleukins; peri-implantitis