Duarte Poliana Mendes, de Mendonça Adriana Cutrim, Máximo Maria Beatriz Braz, Santos Vanessa Renata, Bastos Marta Ferreira, Nociti Francisco Humberto
Department of Periodontics, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil.
J Periodontol. 2009 Feb;80(2):234-43. doi: 10.1902/jop.2009.070672.
The objectives of this study were to clinically and immunologically assess the effects of mechanical anti-infective therapies for mucositis and peri-implantitis and to compare the levels of cytokines in untreated and treated peri-implant diseased sites to healthy ones.
Titanium dental implants were assigned to one of the following groups: healthy (n = 10) = control; mucositis (n = 10) = mechanical debridement using abrasive sodium carbonate air-powder and resin curets; and peri-implantitis (n = 20) = open surgical debridement using abrasive sodium carbonate air-powder and resin curets. Visible plaque accumulation, marginal bleeding, bleeding on probing, suppuration, and probing depth were assessed at baseline for all groups and at 3 months after therapies for diseased groups. At these times, the total amounts of interleukin (IL)-4, -10, and -12, tumor necrosis factor-alpha (TNF-alpha), receptor activator of nuclear factor-kappa B ligand (RANKL), and osteoprotegerin (OPG) in the peri-implant crevicular fluid (PICF) were measured by enzyme-linked immunosorbent assay.
At 3 months, the anti-infective treatments resulted in a significant improvement in all clinical parameters for mucositis and peri-implantitis (P <0.05). Moreover, the total amounts of TNF-alpha in PICF were significantly higher in untreated diseased implants compared to healthy ones, and the OPG/RANKL ratio was higher for healthy implants than for untreated peri-implantitis (P <0.05). TNF-alpha levels were significantly reduced for both diseased groups (P <0.05), achieving the same level as the healthy group at 3 months after therapies (P >0.05).
The proposed anti-infective therapies may locally modulate the levels of TNF-alpha and the OPG/RANKL ratio and improve clinical parameters around peri-implant tissues.
本研究的目的是从临床和免疫学角度评估机械抗感染治疗对黏膜炎和种植体周围炎的效果，并比较未治疗和治疗后的种植体周围病变部位与健康部位的细胞因子水平。
将钛牙种植体分为以下几组：健康组（n = 10）= 对照组；黏膜炎组（n = 10）= 使用磨砂碳酸钠气粉和树脂刮治器进行机械清创；种植体周围炎组（n = 20）= 使用磨砂碳酸钠气粉和树脂刮治器进行开放性手术清创。在基线时评估所有组的可见菌斑堆积、边缘出血、探诊出血、化脓和探诊深度，在病变组治疗后3个月再次评估。在这些时间点，通过酶联免疫吸附测定法测量种植体周围龈沟液（PICF）中白细胞介素（IL）-4、-10和-12、肿瘤坏死因子-α（TNF-α）、核因子-κB受体活化因子配体（RANKL）和骨保护素（OPG）的总量。
3个月时，抗感染治疗使黏膜炎和种植体周围炎的所有临床参数均有显著改善（P <0.05）。此外，与健康种植体相比，未治疗的病变种植体中PICF的TNF-α总量显著更高，健康种植体的OPG/RANKL比值高于未治疗的种植体周围炎（P <0.05）。两个病变组的TNF-α水平均显著降低（P <0.05），治疗后3个月达到与健康组相同的水平（P >0.05）。
所提出的抗感染治疗可能会局部调节TNF-α水平和OPG/RANKL比值，并改善种植体周围组织的临床参数。
