School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
Clin Oral Investig. 2018 Jan;22(1):531-543. doi: 10.1007/s00784-017-2169-0. Epub 2017 Jul 14.
The aim of this study is to improve the understanding of interleukin mechanisms during osseointegration to enhance the monitoring of implant failure and success. Clinical parameters, implant stability, and cytokine levels in peri-implant crevicular fluid (PICF) during early bone healing after implant placement were investigated.
Sixty narrow implants were placed in mandible anterior region of 30 edentulous patients (67.23 ± 7.66 years). Bone type, insertion torque, and primary stability were registered during surgery. Clinical measurements of peri-implant health and the secondary implant stability quotient (ISQ) were recorded. Samples from the PICF were collected 1, 2, 4, 8, and 12 weeks after surgery and analyzed for IL-1β, IL-6, IL-10, and TNF-α levels using ELISAs.
The gingival index increased significantly during the first week (p = 0.05), while the plaque index increased significantly between 4 to 8 and 8 to 12 weeks (p < 0.05). The probing depth and the ISQ also reduced significantly (p < 0.05) over time. The TNF-α release increased significantly after the 2nd week for non-atrophic patients and 4th week for atrophic patients (p < 0.05). The IL-1β concentrations showed a short-lived peak after 1st week (p = 0.003), specially in atrophic patients and sites with bone type I (p = 0.034; p = 0.007). The IL-6 concentrations peaked during the 1st and 2nd weeks (p < 0.05; p = 0.005) in atrophic patients and in bone type II (p = 0.023; p = 0.003). The IL-10 concentrations increased gradually over time, showing the highest concentrations at the 12th week (p < 0.005). A total of 12 implants failed at different periods.
While the clinical measurements presented differences between the evaluation periods, these were not indicative of early dental implant failure or peri-implant diseases. Smoking, bone atrophy, and bone type can greatly influence the cytokines concentrations during the healing time.
本研究旨在提高对骨整合过程中白细胞介素机制的理解，以加强对种植体失败和成功的监测。研究调查了种植体放置后早期骨愈合期间临床参数、种植体稳定性和种植体周围龈沟液（PICF）中的细胞因子水平。
将 60 个窄型种植体植入 30 名无牙患者的下颌前牙区（67.23±7.66 岁）。术中记录骨类型、植入扭矩和初始稳定性。记录种植体周围健康的临床测量值和二次种植体稳定性指数（ISQ）。术后 1、2、4、8 和 12 周采集 PICF 样本，采用 ELISA 法分析 IL-1β、IL-6、IL-10 和 TNF-α 水平。
第 1 周时，牙龈指数显著增加（p=0.05），而菌斑指数在第 4 周至 8 周和第 8 周至 12 周之间显著增加（p<0.05）。探测深度和 ISQ 也随时间显著降低（p<0.05）。非萎缩患者在第 2 周和萎缩患者在第 4 周时 TNF-α 释放显著增加（p<0.05）。IL-1β 浓度在第 1 周后短暂升高（p=0.003），特别是在萎缩患者和骨型 I 的部位（p=0.034；p=0.007）。IL-6 浓度在第 1 周和第 2 周达到峰值（p<0.05；p=0.005），在萎缩患者和骨型 II 中达到峰值（p=0.023；p=0.003）。IL-10 浓度随时间逐渐增加，在第 12 周时达到最高浓度（p<0.005）。共有 12 个种植体在不同时期失败。
虽然临床测量结果在评估期间存在差异，但这些差异并不表明早期牙种植体失败或种植体周围疾病。吸烟、骨萎缩和骨类型会极大地影响愈合期间细胞因子的浓度。
