Isler Sila Cagri, Akca Gulcin, Unsal Berrin, Romanos Georgios, Sculean Anton, Romandini Mario
Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Türkiye.
Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Periodontal Res. 2025 Jul 24. doi: 10.1111/jre.13422.
To assess (i) the risk indicators of peri-implantitis and peri-implant soft-tissue dehiscence (PISTD), and (ii) the accuracy of clinical parameters and peri-implant crevicular fluid (PICF) immunological markers in diagnosing peri-implantitis, within a Turkish university population.
A total of 324 implants in 112 patients were included. The outcomes for the risk indicators analysis were the presence of peri-implantitis and PISTD, with peri-implantitis also serving as the reference standard for the diagnostic accuracy analysis. Several potential risk indicators-including demographic, medical, and dental history, clinical and radiographic parameters, and dental chart data-were assessed using multilevel logistic regressions. The diagnostic performance of clinical parameters and PICF immunological markers was evaluated using logistic regressions and reporting sensitivity, specificity, positive/negative predictive values, and area under the curve (AUC) values.
In the final multilevel logistic regression, the following indicators were associated with peri-implantitis: stage III-IV periodontitis (OR = 5.67), irregular maintenance (SPIC) compliance (OR = 7.71), history of implant loss (OR = 14.44), implant system, absence of keratinized mucosa (KM) (OR = 8.41), and clinical attachment loss in adjacent teeth (OR = 3.75). Risk indicators for PISTD included: mandibular location (OR = 0.22), implant system, absence of KM (OR = 5.95), and mucosal thickness < 2 mm (OR = 197.01). Peri-implant bleeding on probing (BoP) at 2 or more sites had the highest sensitivity for peri-implantitis (98.0%), while the highest specificity was observed for BoP severity (modified Bleeding Index 2-3 = 96.4%). The highest AUC was found for peri-implant probing pocket depth (PPD) ≥ 6 mm (0.88). Among PICF immunological markers, IL-2 and IL-10 exhibited the highest sensitivity (100.0%), while TNF-α had the highest specificity (92.9%). IL-8 and TNF-α had the highest AUC values (0.80).
In this Turkish university cohort, several risk indicators were identified for peri-implantitis and PISTD. Among clinical parameters, only PPD ≥ 6 mm demonstrated strong diagnostic accuracy for peri-implantitis. Several PICF immunological markers, particularly IL-8 and TNF-α, showed promising diagnostic potential.
在土耳其大学人群中，评估（i）种植体周围炎和种植体周围软组织裂开（PISTD）的风险指标，以及（ii）临床参数和种植体周围龈沟液（PICF）免疫标志物在诊断种植体周围炎方面的准确性。
纳入112例患者的324颗种植体。风险指标分析的结果是种植体周围炎和PISTD的存在情况，种植体周围炎也作为诊断准确性分析的参考标准。使用多水平逻辑回归评估了几个潜在的风险指标，包括人口统计学、医学和牙科病史、临床和影像学参数以及牙科图表数据。使用逻辑回归并报告敏感性、特异性、阳性/阴性预测值和曲线下面积（AUC）值来评估临床参数和PICF免疫标志物的诊断性能。
在最终的多水平逻辑回归中，以下指标与种植体周围炎相关：III-IV期牙周炎（OR = 5.67）、不定期维护（SPIC）依从性（OR = 7.71）、种植体丢失史（OR = 14.44）、种植体系统、无角化黏膜（KM）（OR = 8.41）以及相邻牙齿的临床附着丧失（OR = 3.75）。PISTD的风险指标包括：下颌位置（OR = 0.22）、种植体系统、无KM（OR = 5.95）以及黏膜厚度<2 mm（OR = 197.01）。在2个或更多部位探诊时种植体周围出血（BoP）对种植体周围炎的敏感性最高（98.0%），而BoP严重程度（改良出血指数2-3 = 96.4%）的特异性最高。种植体周围探诊袋深度（PPD）≥6 mm的AUC最高（0.88）。在PICF免疫标志物中，IL-2和IL-10的敏感性最高（100.0%），而TNF-α的特异性最高（92.9%）。IL-8和TNF-α的AUC值最高（0.80）。
在这个土耳其大学队列中，确定了种植体周围炎和PISTD的几个风险指标。在临床参数中，只有PPD≥6 mm对种植体周围炎具有较强的诊断准确性。几个PICF免疫标志物，特别是IL-8和TNF-α，显示出有前景的诊断潜力。
