title: Clinical, microbiological, and immunological aspects of healthy versus peri-implantitis tissue in full arch reconstruction patients: a prospective cross-sectional study.
abstract: BACKGROUND
  Due to the world-wide increase in treatments involving implant placement, the incidence of peri-implant disease is increasing. Late implant failure is the result of the inability to maintain osseointegration, whose most important cause is peri-implantitis. The aim of this study was to analyze the clinical, microbiological, and immunological aspects in the peri-implant sulcus fluid (PISF) of patients with healthy dental implants and patients with peri-implantitis.
  
  
  METHODS
  PISF samples were obtained from 24 peri-implantitis sites and 54 healthy peri-implant sites in this prospective cross-sectional study. The clinical parameters recorded were: modified gingival index (mGI), modified plaque index (mPI) and probing pocket depth (PPD). The periodontopathogenic bacteria Tannerella forsythia, Treponema denticola and Porphyromonas gingivalis were evaluated, together with the total bacterial load (TBL). PISF samples were analyzed for the quantification of Interleukin (IL)-8, IL-1β, IL-6, IL-10 and Tumor Necrosis Factor (TNF)-α using flow cytometry (FACS).
  
  
  RESULTS
  The mGI and PPD scores in the peri-implantitis group were significantly higher than the healthy group (p < 0.001). A total of 61.5% of the patients with peri-implantitis had both arches rehabilitated, compared with 22.7% of patients with healthy peri-implant tissues; there was no implant with peri-implantitis in cases that received mandibular treatment exclusively (p < 0.05). Concentrations of Porphyromonas gingivalis (p < 0.01), association with bacteria Porphyromonas gingivalis and Treponema denticola (p < 0.05), as well as the TBL (p < 0.05) are significantly higher in the peri-implantitis group. IL-1β (p < 0.01), IL-6 (p < 0.01), IL-10 (p < 0.05) and TNF-α (p < 0.01) are significantly higher at the sites with peri-implantitis compared to healthy peri-implant tissue, while IL-8 did not increase significantly.
  
  
  CONCLUSIONS
  The results of the present study involving a limited patient sample suggest that the peri-implant microbiota and which dental arch was rehabilitated involved could contribute to bone loss in peri-implantitis. A significant relationship is observed between the concentration of cytokines (interleukins 1β, 6 and 10 and TNF-α) and the inflammatory response in peri-implantitis tissue.
authors.affiliation: Public Dental Health Service, Arnau de Vilanova Hospital, San Clemente Street 12, 46015, Valencia, Spain. javiataali@hotmail.com.|Oral Surgery and Implantology, Valencia University Medical and Dental School, Valencia, Spain. javiataali@hotmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Ata-Ali
authors.affiliation: Oral Surgery and Implantology, Valencia University Medical and Dental School, Valencia, Spain. antonio.flichy@uv.es.
authors.forename: Antonio Juan
authors.initials: AJ
authors.lastname: Flichy-Fernández
authors.affiliation: Valencia University Medical and Dental School, Valencia, Spain. teresaalegre@live.com.
authors.forename: Teresa
authors.initials: T
authors.lastname: Alegre-Domingo
authors.affiliation: Valencia University Medical and Dental School, Valencia, Spain. losataaali@hotmail.com.
authors.forename: Fadi
authors.initials: F
authors.lastname: Ata-Ali
authors.affiliation: Immunology Unit, Institute of Biotechnology and Biomedicine, University of Barcelona, Barcelona, Spain. joseramon.palacio@uab.es.
authors.forename: Jose
authors.initials: J
authors.lastname: Palacio
authors.affiliation: Oral Surgery and Implantology, Valencia University Medical and Dental School, Valencia, Spain. miguel.penarrocha@uv.es.
authors.forename: Miguel
authors.initials: M
authors.lastname: Peñarrocha-Diago
mesh_terms: D000368:Aged; D058491:Bacterial Load; D001439:Bacteroides / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D003724:Dental Arch / Q000473:pathology; D015921:Dental Implants; D003774:Dental Plaque Index; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry* / Q000276:immunology / Q000382:microbiology; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis; D053583:Interleukin-1beta / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008297:Male; D008875:Middle Aged; D057873:Peri-Implantitis / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D010519:Periodontium / Q000033:anatomy & histology* / Q000276:immunology / Q000382:microbiology; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D011446:Prospective Studies; D048373:Treponema denticola / Q000302:isolation & purification; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: C508606:CXCL8 protein, human; D015921:Dental Implants; C508609:IL10 protein, human; C508600:IL6 protein, human; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10