Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey.
Department of Periodontology, Karşıyaka Oral and Dental Health Center, Izmir, Turkey.
J Periodontol. 2019 Jun;90(6):616-626. doi: 10.1002/JPER.18-0216. Epub 2018 Dec 31.
The aim of this trial was to evaluate the cytokine, chemokine, and growth factor levels in peri-implant sulcular fluid (PISF) during healing and osseointegration at osteotomy sites prepared either with piezosurgery (PS) or drills.
Fourteen patients having contralateral partial edentulism in the posterior maxilla were enrolled and 38 osteotomies were prepared. Implants were placed with one-stage surgery. Insertion torque, early healing index, probing depth and modified gingival and plaque indices and crestal bone loss (CBL) were measured. PISF was collected from each implant at weeks 2, 4, 8, 12, and 24 and were analyzed by a 30-Plex immunoassay. Data analysis employed Brunner-Langer method.
CBL values did not depend on osteotomy modality (P > 0.05). Eighteen molecules (interleukine (IL)-1β, granulocyte colony stimulating factor (G.CSF), IL-13, IL-6, IL-12, interferon (IFN)-γ, IFN-α, IL-2, IL-2 R, IL-8, macrophage inflammatory protein (MIP)-1α, MIP-1β, monocyte chemoattractant protein (MCP)-1, interferon gamma-induced protein (IP)-10, monokine induced by IFN-γ (MIG), epidermal growth factor (EGF), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) showed time-dependent decrease (P < 0.05), but they were not treatment-dependent (P > 0.05). When values of weeks 4, 8, 12, and 24 were compared to week 2, it was found that all were highest at week 2 and decreased thereafter (P < 0.05). The decrease was significant at weeks 4 or 8 for multitude of molecules and was mostly sustained throughout the follow-up. Week 8 regulated on activation, normal T cell expressed and secreted (RANTES) values in PS group were lower in PS group compared to drill group (P < 0.05).
Implants placed into osteotomies created with PS and drills are similar in terms of PISF biomarker changes during the osseointegration and wound healing period. When clinical and CBL parameters were taken into account together with the PISF molecular data it can be speculated that PS and conventional drill osteotomy have similar effects on peri-implant tissues on the biochemical, clinical and radiological levels.
本试验旨在评估使用超声骨刀（PS）或钻制备骨切开部位时，种植体周围沟液（PISF）中的细胞因子、趋化因子和生长因子水平在愈合和骨整合期间的变化。
共纳入 14 名上颌后牙区双侧部分缺牙的患者，共制备 38 个骨切开术。采用一期手术植入种植体。测量植入扭矩、早期愈合指数、探诊深度和改良的菌斑指数、牙龈指数以及牙槽嵴骨吸收（CBL）。在第 2、4、8、12 和 24 周时，从每个种植体中收集 PISF，并通过 30 肽免疫分析进行分析。数据分析采用 Brunner-Langer 法。
CBL 值与骨切开术方式无关（P>0.05）。有 18 种分子（白细胞介素（IL）-1β、粒细胞集落刺激因子（G.CSF）、IL-13、IL-6、IL-12、干扰素（IFN）-γ、IFN-α、IL-2、IL-2R、IL-8、巨噬细胞炎症蛋白（MIP）-1α、MIP-1β、单核细胞趋化蛋白（MCP）-1、干扰素γ诱导蛋白（IP）-10、单克隆诱导因子由 IFN-γ（MIG）、表皮生长因子（EGF）、肝细胞生长因子（HGF）、血管内皮生长因子（VEGF）呈时间依赖性降低（P<0.05），但与治疗无关（P>0.05）。当将第 4、8、12 和 24 周的数值与第 2 周进行比较时，发现所有数值均在第 2 周最高，此后逐渐降低（P<0.05）。对于多种分子，第 4 或 8 周的下降具有统计学意义，并且在整个随访期间基本保持不变。PS 组在第 8 周时的 PS 组与钻组相比，调节激活正常 T 细胞表达和分泌（RANTES）值较低（P<0.05）。
使用 PS 和钻制备骨切开术时，种植体周围沟液生物标志物在骨整合和愈合期间的变化相似。当将临床和 CBL 参数与 PISF 分子数据一起考虑时，可以推测 PS 和传统钻骨切开术在生物化学、临床和影像学水平上对种植体周围组织具有相似的作用。
