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Background : Calprotectin and cross-linked N-telopeptides of type I collagen levels in crevicular fluid from implant sites with peri-implant diseases: a pilot study [1]

Background : Calprotectin and cross-linked N-telopeptides of type I collagen levels in crevicular fluid from implant sites with peri-implant diseases: a pilot study [1]

author: Eijiro Sakamoto, Rie Kido, Yoritoki Tomotake, Yoshihito Naitou, Yuichi Ishida, Jun-ichi Kido | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

Dental treatments with implants are now being widely performed due to advances in the development of surgical procedures for dental implants and prosthodontics. However, the incidence of peri-implant diseases has been increasing with implant placement [1], and thus, the early detection of these diseases is important for maintaining dental implants. Peri-implant diseases with inflammation and the destruction of peri-implant tissues have mainly been classified into peri-implantitis with the resorption of alveolar bone around osseointegrated dental implants and peri-implant mucositis without pathological bone resorption [2]. Peri-implant diseases are diagnosed by clinical indicators including probing depth (PD), bleeding on probing (BOP), suppuration, the mobility of an implant, and radiographic bone loss (BL) [3, 4]. Clinical indicators for a diagnosis of peri-implant diseases are similar to the diagnostic indicators for periodontal diseases of natural teeth. However, the measurement of PD using a dental probe is more difficult around dental implants than around natural teeth because peri-implant tissues have less attached gingiva compared with periodontal tissue, and implant structures and prosthetic superstructures sometimes prevent a probing [3, 5]. BL of 2–3 mm on radiographs has been used as a diagnostic standard in cumulative interceptive supportive therapy (CIST) [6]; however, difficulties are associated with obtaining accurate information on slight BL on radiographs in conventional X-ray examinations. The prevalence of peri-implant mucositis and peri-implantitis was previously reported to be between 19 and 65% and between 1 and 47%, respectively [1, 7], and showed a wide range because case definition of peri-implant diseases was different among those studies in which peri-implant diseases were diagnosed using clinical indicators. These reports suggest that the case definition with the diagnosis of peri-implant diseases using clinical indicators is not sufficiently accurate or clear to evaluate pathological conditions.

The diagnosis of peri-implant diseases using biomarkers in peri-implant crevicular fluid (PICF) has recently been examined and may be more accurate than that of clinical indicators to evaluate inflammation and the degradation of tissue surrounding dental implants [4, 7, 8]. PICF contains similar components to gingival crevicular fluid (GCF), namely pro-inflammatory cytokines such as interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), enzymes including aspartate aminotransferase (AST) and collagenase-2 (matrix metalloproteinase-8 (MMP-8)), and bone-related proteins such as cross-linked C-telopeptide of type I collagen (ICTP) and receptor activator of nuclear factor-κB (NF-κB) ligand (RANKL) [9,10,11,12,13]. These factors and proteins in PICF and GCF are regarded as diagnostic biomarkers for peri-implant diseases as well as periodontal diseases.

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