Chaparro Alejandra, Ramírez Valeria, Bendek María José, Nart José, Monje Alberto, Pascual Andrés, Rojas Carolina, Mizgier María Luisa, Albers Daniela, Beltrán Víctor
Department of Oral Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile.
Centro de Investigación e Innovación Biomédica (CIIB), Periodontal Research laboratory (LIP-LAB), Universidad de los Andes, Santiago, Chile.
BMC Oral Health. 2025 Jul 25;25(1):1240. doi: 10.1186/s12903-025-06578-y.
To study the biomarker profile in peri-implant crevicular fluid (PICF) of A proliferation-inducing ligand (APRIL), receptor activator of nuclear factor κβ (RANKL) and interleukin (IL)-23, in healthy, periimplant mucositis and peri-implantitis sites, and to explore their diagnostic accuracy on periimplantitis (PI) diagnosis.
An exploratory cross-sectional study was conducted. Sociodemographic and clinical were recorded. Implant diagnosis was made based on the latest classification consensus. PICF samples were collected with paper strips from healthy, mucositis and PI implants. The biomarkers were analyzed by Luminex assay. The diagnostic accuracy was determined through sensitivity, specificity, predictive values (PV), and receiver operating characteristic (ROC) curves.
Overall, 54 patients were recruited; 17 were healthy implants, 19 with mucositis and 18 have PI. RANKL and APRIL levels in PICF were significantly increased in PI implants compared to healthy implants (p < 0.001 and p = 0.005). IL-23 did not present differences between groups (p > 0.05). Positive correlations between PICF-RANKL levels and clinical attachment loss, plaque index score and bleeding on probing were observed (rho = 0.33; rho = 0.35; rho = 0.33; p < 0.05, respectively). Additionally, PICF-IL-23 and APRIL were correlated with the plaque index score and peri-implant probing depth (rho = 0.28; rho = 0.28, p < 0.05). PICF-APRIL concentrations and plaque index score were associated with PI (OR:3.01; 95%CI [1.08-8.38], p = 0.035, and OR:11.24; 95% CI [2.63-48.16], p = 0.001, respectively). The regression model, which included PICF-APRIL and plaque index, showed an AUC-ROC of 0.95, a sensitivity of 94.4%, 83.3% specificity, a positive PV of 73.9%, and a negative PV of 96.8%.
Implants with PI have higher levels of APRIL and RANKL in PICF compared to healthy implants. The model that includes the levels of APRIL in PICF combined with the plaque index score leads to an enhanced accuracy of PI diagnosis.
Clinical diagnosis of peri-implant disease can be improved with molecular tools, in this case, APRIL demonstrated high accuracy for the diagnosis of PI.
研究增殖诱导配体（APRIL）、核因子κβ受体激活剂（RANKL）和白细胞介素（IL）-23在健康、种植体周围黏膜炎和种植体周围炎部位的种植体周围龈沟液（PICF）中的生物标志物谱，并探讨它们对种植体周围炎（PI）诊断的准确性。
进行一项探索性横断面研究。记录社会人口统计学和临床资料。根据最新的分类共识进行种植体诊断。用纸条从健康、黏膜炎和PI种植体中收集PICF样本。通过Luminex检测法分析生物标志物。通过敏感性、特异性、预测值（PV）和受试者工作特征（ROC）曲线确定诊断准确性。
总体而言，招募了54名患者；17个为健康种植体，19个有黏膜炎，18个有PI。与健康种植体相比，PI种植体中PICF的RANKL和APRIL水平显著升高（p < 0.001和p = 0.005）。IL-23在各组之间无差异（p > 0.05）。观察到PICF-RANKL水平与临床附着丧失、菌斑指数评分和探诊出血之间存在正相关（rho分别为0.33；0.35；0.33；p < 0.05）。此外，PICF-IL-23和APRIL与菌斑指数评分和种植体周围探诊深度相关（rho分别为0.28；0.28，p < 0.05）。PICF-APRIL浓度和菌斑指数评分与PI相关（OR分别为：3.01；95%CI [1.08 - 8.38]，p = 0.035，以及OR为：11.24；95%CI [2.63 - 48.16]，p = 0.001）。包含PICF-APRIL和菌斑指数的回归模型显示AUC-ROC为0.95，敏感性为94.4%，特异性为83.3%，阳性预测值为73.9%，阴性预测值为96.8%。
与健康种植体相比，患有PI的种植体PICF中的APRIL和RANKL水平更高。包含PICF中APRIL水平与菌斑指数评分的模型提高了PI诊断的准确性。
分子工具可改善种植体周围疾病的临床诊断，在这种情况下，APRIL对PI诊断具有较高准确性。
