Changes in inflammatory mediators in peri-implant fluid after implant insertion.

BACKGROUND: Endosseous dental titanium implants have revolutionized restorative dentistry and have made a significant impact on improved patient care. The aim of this study was to compare and evaluate the influence of the placement technique on periodontal health. METHODS: A baseline examination was performed in patients with submerged and non-submerged titanium implants, including an evaluation of plaque index (PI), gingival index (GI), periodontal probing depth (PD), clinical attachment level (CAL), and bone level, as well as histamine and arachidonic acid metabolite concentrations, in the peri-implant crevicular fluid. Examinations were repeated after 12, 24, and 36 months. RESULTS: Bone loss was significantly higher in the submerged group relative to the non-submerged group at 3 years (P <0.01), with a slight increase at 24 months. All clinical parameters were significantly higher in the submerged group relative to the non-submerged group at 24 and 36 months (P <0.05 for PI; P <0.01 for GI, PD, and CAL). The mean levels of histamine and other inflammatory mediators were significantly higher, whereas 15(S)-hydroxy-5,8,11,13-eicosatetraenoic acid concentrations were significantly reduced in the submerged group, with a high correlation with periodontal indices at 24 and 36 months (P <0.001). CONCLUSION: This longitudinal study suggested that submerged implants present a number of risks for periodontal complications compared to non-submerged implants, which can be evidenced by inflammatory mediator variations in the peri-implant crevicular fluid.

Salivary histamine level as a predictor of periodontal disease in type 2 diabetic and non-diabetic subjects.

BACKGROUND: Some previous investigations underscored the role of histamine in periodontal disease, especially in diabetic patients, but the behavior of this inflammatory mediator in the early phases of periodontal involvement remains unclear. The aim of the present study was to correlate the presence of histamine in saliva with clinical parameters in healthy, periodontitis-affected, and diabetic subjects to ascertain whether this amine may serve as a predictive index of periodontal risk. METHODS: For this purpose, subjects were selected as follows: 1) with newly diagnosed type 2 diabetes mellitus; 2) with neither diabetes nor periodontitis; 3) with no diabetes but with chronic, untreated periodontal disease. Histamine salivary levels were measured at the initial time (T0) and after 6, 12, and 24 months using high-performance liquid chromatography. The main periodontal indexes were recorded at the same time intervals. RESULTS: At T0, a very typical shape of the histamine chromatogram was found for all patients of the three groups; at this time, the salivary histamine levels of diabetic patients were increased and comparable to those of healthy patients with periodontal disease, whereas healthy subjects with no periodontitis showed reduced histamine levels. Further controls at 6, 12, and 24 months showed a statistically significant correlation between the increase of salivary histamine and the worsening of the periodontal indexes in diabetic and non-diabetic subjects. CONCLUSION: These results suggest that salivary histamine may serve as a predictive index in the prevention of periodontal disease.