State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China.
J Periodontol. 2024 Mar;95(3):233-243. doi: 10.1002/JPER.23-0167. Epub 2023 Sep 14.
Clinical probing is commonly recommended to evaluate peri-implant conditions. In a situation of peri-implant mucositis or peri-implantitis, the peri-implant seal healing from the disruption of soft tissue caused by probing has not yet been studied. This study aimed to investigate soft tissue healing after standardized clinical probing around osseointegrated implants with peri-implant mucositis in a dog model.
Three transmucosal implants in each hemi-mandible of six dogs randomly assigned to the peri-implant healthy group or peri-implant mucositis group were probed randomly in the mesial or distal site as probing groups (PH or PM), the cross-sectional opposite sites as unprobed control groups. Histomorphometric measurements of implant shoulder (IS)-most coronal level of alveolar bone contact to the implant surface (BCI), apical termination of the junctional epithelium (aJE)-BCI, mucosal margin (MM)-BCI, and MM-aJE were performed at 1 day, 1 week, and 2 weeks after probing. Apoptosis, proliferation, proinflammatory cytokines, and matrix metalloproteinases (MMPs) of peri-implant soft tissue were estimated by immunofluorescent analysis.
In the PM group, apical migration of junctional epithelium was revealed by significantly decreased aJE-BCI from 1 day to 2 weeks in comparison to unprobed sites (p < 0.05), while no significant differences were found in the PH group. Immunofluorescent analysis showed higher levels of interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α), MMP-1, and MMP-8, together with exaggerated apoptosis and proliferation of peri-implant soft tissue in the PM group.
Within the limitations, standardized clinical probing might lead to apical migration of the junctional epithelium in a situation of peri-implant mucositis.
临床探诊常用于评估种植体周围状况。在种植体周围黏膜炎或种植体周围炎的情况下，尚未研究过因探诊而破坏软组织后种植体周围的密封愈合情况。本研究旨在探讨犬模型中种植体周围黏膜炎条件下，标准化临床探诊对种植体周围软组织愈合的影响。
将 6 只狗的每侧下颌骨中的 3 个黏膜下种植体随机分配到种植体健康组或种植体周围黏膜炎组，在近中或远中位点进行随机探诊作为探诊组（PH 或 PM），对交叉对照位点不进行探诊作为未探诊对照组。在探诊后 1 天、1 周和 2 周，对种植体肩（IS）-最冠方牙槽骨与种植体表面接触（BCI）、结合上皮根尖终止（aJE）-BCI、黏膜边缘（MM）-BCI 和 MM-aJE 进行组织形态计量学测量。通过免疫荧光分析评估种植体周围软组织的细胞凋亡、增殖、促炎细胞因子和基质金属蛋白酶（MMPs）。
在 PM 组中，与未探诊位点相比，探诊后第 1 天至第 2 周时，结合上皮的根尖迁移导致 aJE-BCI 显著减少（p<0.05），而在 PH 组中未发现显著差异。免疫荧光分析显示，PM 组中白细胞介素 1β（IL-1β）、白细胞介素 6（IL-6）、肿瘤坏死因子-α（TNF-α）、MMP-1 和 MMP-8 的水平更高，同时种植体周围软组织的细胞凋亡和增殖加剧。
在本研究限制范围内，标准化临床探诊可能导致种植体周围黏膜炎情况下结合上皮的根尖迁移。
