Kalsi Amardip Singh, Moreno Federico, Petridis Haralampos
Department of Restorative Dentistry, Cambridge University Hospitals, Cambridge, UK.
Unit of Periodontics, UCL Eastman Dental Institute, London, UK.
J Periodontal Implant Sci. 2021 Feb;51(1):3-17. doi: 10.5051/jpis.1902840142.
The pathology of peri-implantitis is still not fully understood and there have been recent challenges to the consensus on its aetiology and pathology, especially in comparison with periodontitis. The assessment of biomarkers allows a comparison of the pathology of these diseases. The aim of this systematic review was to answer the research question: "Is there a difference in the biomarkers associated with peri-implantitis compared with periodontitis in adult humans?"
Electronic databases were searched and screened, and a manual search was also undertaken. The inclusion criteria were adults with peri-implantitis who had been compared to adults with periodontitis with the outcome of biomarkers assessed via biopsies or crevicular fluid samples in primary or secondary care settings, as recorded in case-control, case series and retrospective, prospective and cross-sectional observational studies. Two reviewers independently screened titles and abstracts and assessed full text articles for eligibility and inclusion. Both reviewers independently extracted data and assessed risk of bias. Differences in biomarker levels were the primary outcome and a narrative review was undertaken due to the heterogeneity of studies.
In total, 2,374 articles were identified in the search, of which 111 full-text articles were assessed for eligibility and 13 were included in the qualitative synthesis. Five of the 13 included studies were deemed to be at high risk of bias, with the others having moderate risk. All studies were cross-sectional and performed at university hospitals. Nine of the 13 included studies found significant differences in the levels of biomarkers or their ratios between peri-implantitis and periodontitis. Four of the studies found no significant differences.
Within the limitations of the included studies, it appears that there may be a difference in biomarker levels and ratios between peri-implantitis and periodontitis, suggesting that these disease processes are somewhat distinct.
种植体周炎的病理机制仍未完全明确，近期其病因和病理的共识受到了挑战，尤其是与牙周炎相比。生物标志物的评估有助于比较这些疾病的病理情况。本系统评价的目的是回答研究问题：“在成年人类中，与牙周炎相比，种植体周炎相关的生物标志物是否存在差异？”
检索并筛选电子数据库，同时进行手工检索。纳入标准为患有种植体周炎的成年人，他们与患有牙周炎的成年人进行了比较，通过活检或龈沟液样本在初级或二级医疗环境中评估生物标志物的结果，如病例对照研究、病例系列研究以及回顾性、前瞻性和横断面观察性研究中所记录的那样。两名 reviewers 独立筛选标题和摘要，并评估全文文章的 eligibility 和纳入情况。两名 reviewers 均独立提取数据并评估偏倚风险。生物标志物水平的差异是主要结局，由于研究的异质性，进行了叙述性综述。
在检索中总共识别出 2374 篇文章，其中 111 篇全文文章被评估 eligibility，13 篇纳入定性综合分析。13 项纳入研究中有 5 项被认为存在高偏倚风险，其他研究具有中度风险。所有研究均为横断面研究，且在大学医院进行。13 项纳入研究中有 9 项发现种植体周炎和牙周炎之间生物标志物水平或其比率存在显著差异。4 项研究未发现显著差异。
在所纳入研究的局限性内，种植体周炎和牙周炎之间的生物标志物水平和比率似乎可能存在差异，这表明这些疾病过程在一定程度上是不同的。
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