Machtei Eli E, Oved-Peleg Efrat, Peled Micha
Unit of Periodontology, Technion-Israeli Institute of Technology, Haifa, Israel.
Clin Oral Implants Res. 2006 Dec;17(6):658-65. doi: 10.1111/j.1600-0501.2006.01282.x.
A comparison between host response in teeth and dental implants was not made. Likewise, the association between host response and periodontal parameters has never been explored. The purpose of this study was to compare periodontal health around natural teeth and dental implants with different restorative platforms. Twenty-seven partially edentulous patients with dental implants, either external hex butt joint (n=28) or tapered Morse (n=45), were included in this study. Implants were in function for 1-6 years (mean 2.9). Plaque index (PI), gingival index (GI), probing depth (PD); and clinical attachment level (CAL), were recorded at final examination; alveolar bone loss (ABL) was measured at baseline and final examination using panoramic radiographs. Gingival crevicular fluid samples were obtained from the Ramfjord index teeth and all implants and assayed using enzyme-linked immunosorbent assay for prostaglandin E(2) (PGE(2)), interleukin-1 (IL-1) and tumour necrosis factor alpha (TNFalpha). Differences between teeth and implants and between the two implant platforms were compared using Student's t-test. Correlations between cytokines, ABL and clinical parameters were analyzed using Pearson's co-efficient test. PI and GI were significantly higher in teeth than dental implants (1.2+/-0.5 vs. 0.8+/-0.5, P=0.0018; 1.2+/-0.3 vs. 1.1+/-0.3, P=0.048). Conversely, PD was deeper in implants (2.66+/-0.6 vs. 3.66+/-0.9, P=0.001). GI and PD around teeth and implants were positively associated (R=0.561, P=0.0023; R=0.39, P=0.0452). Greater ABL was observed around dental implants (1.62+/-2.2 mm) compared with teeth (0.49+/-0.3 mm). A positive correlation was found between both IL-1 (R=0.73, P=0.0064; R=0.52, P=0.0081) and TNFalpha (R=0.64, P=0.0246; R=0.46, P=0.091) and ABL in teeth and implants. Both implant platforms were similar clinically and radiographically; however, TNFalpha (2.49+/-0.3 vs. 4.79+/-0.5, P=0.004) and IL-1 (24.52+/-7.3 vs. 45.41+/-9.9, P=0.095) were higher for the non-submerged implants. In conclusion, IL-1 and TNFalpha are sensitive markers of ABL around teeth and implants. The two dental implant platforms showed a similar clinical and radiographic response; however, the greater host response in the non-submerged implants might suggest future bone loss.
本研究未对牙齿和牙种植体的宿主反应进行比较。同样，宿主反应与牙周参数之间的关联也从未被探究过。本研究的目的是比较不同修复平台下天然牙和牙种植体周围的牙周健康状况。本研究纳入了27例部分牙列缺损且植入了牙种植体的患者，其中外部六角对接式（n = 28）或锥形莫氏（n = 45）。种植体使用1 - 6年（平均2.9年）。在最终检查时记录菌斑指数（PI）、牙龈指数（GI）、探诊深度（PD）和临床附着水平（CAL）；使用全景X线片在基线和最终检查时测量牙槽骨吸收（ABL）。从Ramfjord指数牙和所有种植体获取龈沟液样本，并使用酶联免疫吸附测定法检测前列腺素E(2)（PGE(2)）、白细胞介素-1（IL-1）和肿瘤坏死因子α（TNFα）。使用学生t检验比较牙齿和种植体之间以及两种种植体平台之间的差异。使用Pearson相关系数检验分析细胞因子、ABL和临床参数之间的相关性。牙齿的PI和GI显著高于牙种植体（1.2±0.5对0.8±0.5，P = 0.0018；1.2±0.3对1.1±0.3，P = 0.048）。相反，种植体的PD更深（2.66±0.6对3.66±0.9，P = 0.001）。牙齿和种植体周围的GI和PD呈正相关（R = 0.561，P = 0.0023；R = 0.39，P = 0.0452）。与牙齿（0.49±0.3 mm）相比，牙种植体周围观察到更大的ABL（1.62±2.2 mm）。在牙齿和种植体中，IL-1（R = 0.73，P = 0.0064；R = 0.52，P = 0.0081）和TNFα（R = 0.64，P = 0.0246；R = 0.46，P = 0.091）与ABL均呈正相关。两种种植体平台在临床和影像学上相似；然而，非潜入式种植体的TNFα（2.49±0.3对4.79±0.5，P = 0.004）和IL-1（24.52±7.3对45.41±9.9，P = 0.095）更高。总之，IL-1和TNFα是牙齿和种植体周围ABL的敏感标志物。两种牙种植体平台显示出相似的临床和影像学反应；然而，非潜入式种植体中更大的宿主反应可能提示未来的骨质流失。
