Sánchez-Fernández Elena, Magán-Fernández Antonio, O'Valle Francisco, Bravo Manuel, Mesa Francisco
Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.
Department of Periodontics, School of Dentistry, University of Granada, Granada, Spain.
J Periodontal Implant Sci. 2021 Feb;51(1):63-74. doi: 10.5051/jpis.1903660183.
This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)-1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis.
A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient.
Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, -1.66, -0.40 mm; control 2: 95% CI, -1.07, -0.01 mm) and 90 days (control 1: 95% CI, -1.72, -0.54 mm; control 2: 95% CI, -1.13, -0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (=0.04).
This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels.
ClinicalTrials.gov Identifier: NCT03157193.
本研究调查了透明质酸（HA）对种植体周围炎患者种植体周围临床变量以及龈沟液中促炎生物标志物白细胞介素（IL）-1β和肿瘤坏死因子（TNF）-α浓度的影响。
对种植体周围炎患者进行了一项随机对照试验。患者被随机分为接受0.8% HA凝胶（试验组）、赋形剂基凝胶（对照组1）或不使用凝胶（对照组2）。评估了治疗0、45和90天后的临床牙周变量和边缘骨丢失情况。在基线和治疗45天后，通过酶联免疫吸附测定法测量龈沟液中IL-1β和TNF-α水平。考虑到单个患者可能有多个种植体，进行了聚类分析。
61例患者的100颗牙种植体被分配到试验组、对照组1或对照组2。在45天（对照组1：95%CI，-1.66，-0.40mm；对照组2：95%CI，-1.07，-0.01mm）和90天（对照组1：95%CI，-1.72，-0.54mm；对照组2：95%CI，-1.13，-0.15mm）时，试验组的探诊深度（PPD）显著低于两个对照组。在90天时，试验组探诊出血趋势低于对照组2（P=0.07）。在45天时，PPD≥5mm的种植体在对照组2中的IL-1β水平高于试验组（P=0.04）。
本研究首次证明，在种植体周围袋内及种植体周围炎种植体周围局部应用HA凝胶可能会减轻炎症并降低龈沟液IL-1β水平。
ClinicalTrials.gov标识符：NCT03157193。
