The Institute for Postgraduate Dental Education, Jönköping, Sweden.
Clin Implant Dent Relat Res. 2012 Oct;14(5):723-36. doi: 10.1111/j.1708-8208.2010.00309.x. Epub 2010 Nov 18.
Early detection of healing complications after placement of dental implants is a pressing but elusive goal. This paper proposes a non-invasive diagnostic tool for monitoring healing- and peri-implant disease specific genes, complementary to clinical evaluations.
Eighteen partially edentulous patients were recruited to this pilot study. Three Brånemark TiUnite® implants/patient (Nobel Biocare) were placed in a one-stage procedure. Abutments with smooth or rough (TiUnite®) surface were placed. The test group (n = 9) received fixed bridges (immediate loading), whereas the control group (n = 9) implants were loaded 3 months after surgery. In addition to clinical measurements, crevicular fluid was collected using paper strips at the implant abutments 2, 14, 28, and 90 days postoperative. mRNA was extracted, purified, and converted to cDNA. Quantitative PCR assays for IL-1β, TNF-α, Osteocalcin (OC), Alkaline Phosphatase (ALP), Cathepsin K, Tartrate Resistant Acid Phosphatase, and 18S ribosomal RNA were designed and validated. Relative gene expression levels were calculated.
One implant was lost in the control group and three in the test group. In one test patient, one implant showed lowered stability after 2 to 4 weeks and was unloaded. Later implant stability improved which allowed for loading after 3 to 4 months. TNF-α and ALP most commonly showed correlation with clinical parameters followed by IL-1β and OC. The strongest correlation was found for TNF-α with clinical complications at 2 and 14 days (p = .01/r = -048, and p = .0004/r = -0.56, respectively; test and control groups together). In some cases, gene expression predicted clinical complications (TNF-α, ALP, CK).
This study is based on samples from few individuals; still, some genes showed correlation with clinical findings. Further studies are needed to refine and optimize the sampling process, to find the appropriate panel, and to validate gene expression for monitoring implant healing.
早期发现牙种植体植入后愈合并发症是一个紧迫但难以实现的目标。本文提出了一种非侵入性的诊断工具，用于监测愈合和种植体周围疾病特异性基因，与临床评估互补。
本研究纳入了 18 名部分缺牙患者。每位患者（Nobel Biocare）植入 3 颗 Brånemark TiUnite®种植体。采用一期手术植入。基台采用光滑或粗糙（TiUnite®）表面。实验组（n=9）接受固定桥（即刻负载），对照组（n=9）则在手术后 3 个月负载。除了临床测量外，还在术后第 2、14、28 和 90 天使用纸条收集种植体基台处的龈沟液。提取、纯化 mRNA，并转化为 cDNA。设计并验证了 IL-1β、TNF-α、骨钙素（OC）、碱性磷酸酶（ALP）、组织蛋白酶 K、抗酒石酸酸性磷酸酶和 18S 核糖体 RNA 的定量 PCR 检测。计算相对基因表达水平。
对照组中有 1 颗种植体脱落，实验组中有 3 颗种植体脱落。在一名实验组患者中，1 颗种植体在 2 至 4 周后出现稳定性下降，随后被卸下。随后种植体稳定性改善，在 3 至 4 个月后重新负载。TNF-α 和 ALP 与临床参数最常相关，其次是 IL-1β 和 OC。在第 2 和 14 天，TNF-α与临床并发症的相关性最强（p =.01/r = -0.48 和 p =.0004/r = -0.56；实验组和对照组一起）。在某些情况下，基因表达可预测临床并发症（TNF-α、ALP、CK）。
本研究基于少数个体的样本；尽管如此，一些基因与临床发现相关。需要进一步研究来优化采样过程，寻找合适的基因表达谱，并验证基因表达以监测种植体愈合。
