Effect of Anti‐Infective Mechanical Therapy on Clinical Parameters and Cytokine Levels in Human Peri‐Implant Diseases

Abstract

Background: The objectives of this study were to clinically and immunologically assess the effects of mechanical anti‐infective therapies for mucositis and peri‐implantitis and to compare the levels of cytokines in untreated and treated peri‐implant diseased sites to healthy ones. Methods: Titanium dental implants were assigned to one of the following groups: healthy (n = 10) = control; mucositis (n = 10) = mechanical debridement using abrasive sodium carbonate air‐powder and resin curets; and peri‐implantitis (n = 20) = open surgical debridement using abrasive sodium carbonate air‐powder and resin curets. Visible plaque accumulation, marginal bleeding, bleeding on probing, suppuration, and probing depth were assessed at baseline for all groups and at 3 months after therapies for diseased groups. At these times, the total amounts of interleukin (IL)‐4, −10, and −12, tumor necrosis factor‐alpha (TNF‐α), receptor activator of nuclear factor‐kappa B ligand (RANKL), and osteoprotegerin (OPG) in the peri‐implant crevicular fluid (PICF) were measured by enzyme‐linked immunosorbent assay. Results: At 3 months, the anti‐infective treatments resulted in a significant improvement in all clinical parameters for mucositis and peri‐implantitis ( P <0.05). Moreover, the total amounts of TNF‐α in PICF were significantly higher in untreated diseased implants compared to healthy ones, and the OPG/RANKL ratio was higher for healthy implants than for untreated peri‐implantitis ( P <0.05). TNF‐α levels were significantly reduced for both diseased groups ( P <0.05), achieving the same level as the healthy group at 3 months after therapies ( P >0.05). Conclusion: The proposed anti‐infective therapies may locally modulate the levels of TNF‐α and the OPG/RANKL ratio and improve clinical parameters around peri‐implant tissues.