Immunohistochemical analysis with apoptosis and autophagy markers in periodontitis and peri-implantitis: Clinical comparative study.

BACKGROUND AND OBJECTIVES: Recently, the terms autophagy and apoptosis have been studied on implants, especially in cell culture and in vitro studies, but in vivo evaluations are limited. The aim of this study was to compare the differences in apoptosis and autophagy intensity at the molecular and cellular level in periodontal and peri-implant diseases. METHODS: Sixty-four biopsy samples were obtained from 52 patients, 36 female and 16 male, whose mean age was between 18 and 75, and were included in the study. The periodontitis group was defined as PG (n:30 sample) and the peri-implantitis group as IG (n:34 samples). Granulation tissues as biopsy materials were collected, and immunohistochemical analysis was performed with hematoxylin-eosin, Masson's trichrome, anti-MAP1LC3A, anti-beclin, and anti-active caspase-3 antibodies and terminal TdT-mediated dUTP-biotin nick end labeling (TUNEL) methods. The histological slide images were evaluated with the ImageJ software program. Inflammatory cell density in epithelial tissue, inflammatory cell density in connective tissue, the density of necrotic tissue debris, and collagen density in connective tissue were scored between 0 and 3 (0: none, 1: minimal, 2: moderate, 3: severe by hematoxylin-eosin and Masson's trichrome). The antibody binding reaction areas were evaluated per unit area (mm2 ) in connective tissue by immunohistochemical examination. RESULTS: As histochemical evaluations, there was no statistically significant differences the mean inflammatory cell density value in the epithelial tissue, inflammatory cell density value in the connective tissue, density value of necrotic tissue debris, collagen density value in the connective tissue between the groups. There was no statistically significant difference on immunohistochemical staining with LC3, caspase-3, Beclin-1 and TUNEL between the two groups (p > .05). CONCLUSIONS: A higher rate of inflammatory accumulation was shown on peri-implantitis, but no difference was found between periodontitis and peri-implantitis according to autophagy and apoptosis markers. Studies with high sample sizes with different markers are needed.

Chemical Evaluation of Energy Dispersive X-ray Spectroscopy Analysis of Different Failing Dental Implant Surfaces: A Comparative Clinical Trial.

The aim of the present study is to compare two different implant surface chemistries of failing dental implants. Sixteen patients (mean age: 52 ± 8.27 with eight females and eight males) and 34 implants were included in the study. Group-I implants consisted of a blasted/etched surface with a final process surface, while Group-II implants consisted of the sandblasted acid etching (SLA) method. The chemical surface analysis was performed by the energy dispersive X-ray spectroscopy (EDX) method from coronal, middle, and apical parts of each implant. Titanium (Ti) element values were found to be 20.22 ± 15.7 at.% in Group I and 33.96 ± 13.62 at.% in Group-II in the middle of the dental implants. Aluminum (Al) element values were found to be 0.01 ± 0.002 in Group-I and 0.17 ± 0.28 at.% in Group II in the middle of the dental implants, and statistically significant differences were found between the groups for the Al and Ti elements in the middle of the dental implants (p < 0.05). There was a statistically significant difference for the Ti, Al, O, Ca, Fe, P, and Mg elements in the coronal, middle, and apical parts of the implants in the intragroup evaluation (p < 0.05). It is reported that different parts of the implants affected by peri-implant inflammation show different surface chemistries, from coronal to apical, but there is no difference in the implants with different surfaces.

Platform-switched implants vs platform-matched implants placed in different implant-abutment interface positions: A prospective randomized clinical and microbiological study.

BACKGROUND: Placement of the implant-abutment interface (IAI) away from the bone crest has been suggested to have positive impacts on maintenance of peri-implant tissues. PURPOSE: To assess the effects of platform-switched and platform-matched implants, taking into consideration the IAI at different positions relative to the bone crest, on clinical, radiographic, and microbiological outcomes during 12 months following functional loading. MATERIALS AND METHODS: The present prospective randomized study was performed upon 70 patients. Group I (n = 23) implants presenting a platform-switched implant-abutment connection design was inserted 1 mm subcrestally. Group II (n = 22) implants with similar properties were inserted crestally. Group III (n = 25) implants presenting a platform-matched approach with an internal hexagon connection design was inserted crestally. The periodontal parameters were assessed at baseline, and 3, 6, and 12 months postloading. Radiographic marginal bone level (MBL) changes were analyzed at the 12-month follow-up. The amount of DNA copies of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Provetalla intermedia and total bacterial mean load in peri-implant sulcus fluid (PISF) were assessed at the same periods. RESULTS: There were no significant differences among the groups with respect to the periodontal parameters for all time periods. At 12-month follow-up, the MBL changes were 0.16 ± 0.29 mm and 0.17 ± 0.23 mm for group I, 0.15 ± 0.25 mm and 0.17 ± 0.26 mm for group II, 0.17 ± 0.26 mm and for group III in mesial and distal sites, respectively. The mean total bacterial load was found significantly higher for group III compared to the other groups in the three interval times (P < .05). CONCLUSION: Implants restored with platform-switching and platform-matching performed equally regarding clinical and radiographic outcomes. Platform-matched implants inserted at the crestal level presented higher the mean bacterial total load in PISF.

Comparison of the clinical, radiographic, and histological effects of titanium-prepared platelet rich fibrin to allograft materials in sinus-lifting procedures.

AIM: In the present study, we evaluated the clinical, radiographic, and histological comparisons of completely autologous titanium-prepared platelet rich fibrin (T-PRF) or allograft in sinus-lifting procedures. METHODS: Eighteen posterior maxilla requiring sinus-lifting procedures using the balloon-lifting technique for implant placement were selected. Ten sinuses were randomly assigned to T-PRF as the test group and eight to allografts as the control group. After 4 and 6 months in the test and control groups, respectively, computed tomography was done, and bone samples were received during implant surgery. Three months after the second surgery, implant stability was measured. RESULTS: Radiological results showed that the allograft group had better results (62% in volume, 53% in density, and 69% in height) than the T-PRF group. Histomorphometric results showed that newly-formed bone ratios were 17.28 ± 2.53 and 16.58 ± 1.05 in the allograft group and T-PRF groups, respectively. There was no significant difference between the test and control groups (P = .611) for implant stability values. CONCLUSIONS: The use of T-PRF alone in sinus-lifting operations has successful clinical and histomorphometric results. Bone formation in the T-PRF group was accelerated to 4 months compared to allografts according to the histological results.

The Comparison of Porous Titanium Granule and Xenograft in the Surgical Treatment of Peri-Implantitis: A Prospective Clinical Study.

BACKGROUND: Regarding the current approach, there is no evidence to show which treatment technique is the most accurate and useful in peri-implant defects. PURPOSE: The aim of this study is comparing the effect of porous titanium granule (PTG) with rotary titanium brush and the use of xenograft and collagen membrane in the treatment of intra-bony peri-implant defects. MATERIALS AND METHODS: Twenty-two patients, suffering peri-implantitis defects were included this study. Patients were divided into two groups: The PTG group used rotary titanium brush, PTG, and platelet rich fibrin (PRF) membrane. The XGF group used xenograft bone substitute, collagen membrane, and PRF membrane. Clinical measurements and cone beam computed tomography per region were recorded as baseline and sixth month after surgery. RESULTS: The mean CAL values were improved from 5.29 ± 1.06 to 3.59 ± 0.88 mm in PTG group, while in XGF group; these values were improved from 4.77 ± 1.05 to 3.30 ± 0.58 mm. Radiographic bone filling values displayed a statistically significant difference between of groups. In PTG groups, these radiological values increased more than the XGF group. CONCLUSIONS: PTG may be more appropriate for peri-implantitis surgery than xenograft due to inert structure and comfortable use of PTG to provide mechanical support for enlarging the surface area of the implant.

The effect of low-level laser therapy on non-surgical periodontal treatment: a randomized controlled, single-blind, split-mouth clinical trial.

The purpose of this split-mouth, single-blind, controlled clinical study was to evaluate the impact of low-level laser therapy (LLLT) as an adjunct to non-surgical treatment of chronic periodontitis. Twenty-five systemically healthy and non-smoking adults with chronic periodontitis who had at least two bilateral premolar teeth with probing pocket depth (PPD) of 7 ≥ x ≥ 5 mm were included in the study. In the periodontal examination of these patients, PPD, gingival index (GI), plaque index (PI), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at the baseline, first, third, and sixth months after treatment. Gingival crevicular fluid (GCF) samples were taken at the baseline, first week, and first month after treatment. The collected GCF samples were analyzed using the MAGPIX™ system with a Bio-Plex Pro™ Human Cytokine 27-plex kit. After non-surgical periodontal treatment, LLLT with an energy density of 7.64 J/cm2 was performed four times: immediately after scaling and root planning (SRP) and on the first, third, and seventh day after treatment. In the first month, PPD levels were significantly (p < 0.05) lower in the SRP + LLLT group than in the SRP group. At the third and sixth months, CAL, PPD, and GI were significantly (p < 0.05) lower in the SRP + LLLT group than in the SRP group. Differences in GCF cytokines levels among the group were not statistically significant. Within the limitations of this study, it is indicated that LLLT as an adjunct to non-surgical periodontal treatment has a positive impact on clinical parameters.

Effect of different localizations of microgap on clinical parameters and inflammatory cytokines in peri-implant crevicular fluid: a prospective comparative study.

The purpose of this study was to evaluate the effect of microgap on clinical and biochemical parameters around dental implants for 1 year. All patients received four implants: group A-Standard Straumann(®) implants, group B-1 mm subcrestal placement of the polished surface of group A implants, group C-esthetic plus Straumann® implants, group D-subcrestal placement of the polished surface of group C implants. Clinical measurements and peri-implant crevicular fluid (PICF) were collected immediately before loading and at 3rd, 6th, and 12th months after loading, and interleukin-1 beta (IL-1ß) and tumor necrosis factor-alpha (TNF-α) have been assessed in the crevicular fluid. No significant differences were found in plaque index, gingival index, and probing between the groups throughout the study. However, the PICF volumes of group D were significantly higher than that in the other groups, and group A were significantly lower than the other groups (P < 0.05). With respect to bleeding on probing values, the percentage of BOP (+) sides in group A implants were fewer than group C and D implants (P < 0.05). With regard to IL-1ß, the levels of IL-1ß in group A were lower than that in the other groups during the study (P < 0.05). In point of TNF-α total amounts, the levels of TNF-α in group A implants were lower than those in group B and D implants (P < 0.05). Moving microgap coronally from alveolar crest could be recommended for the health of periodontal tissues. Most coronal location of microgap can be suggested in order to maintain the peri-implant health status, particularly in implant sites without esthetic priority.

Evaluation of matrix metalloproteinase-1 and tissue inhibitor of metalloproteinase-1 levels in gingival fibroblasts of cyclosporin A-treated patients.

BACKGROUND: Cyclosporin A (CsA) is a potent immunosuppressant used to prevent organ transplant rejection and to treat various autoimmune diseases. CsA-induced gingival overgrowth (CsA GO) is the most widely seen side effect of this drug; its pathogenesis is not completely understood. The aim of this study was to identify and compare matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in gingival fibroblast cultures of tissues derived from renal transplant patients receiving CsA and exhibiting gingival overgrowth and from periodontally healthy control subjects. METHODS: Gingival overgrowth samples were obtained from patients undergoing therapy with CsA, and control tissues were obtained from systemically healthy donors. Gingival fibroblasts were grown using explant cultures. Three different study groups were identified: 1) CsA GO fibroblast culture; 2) CsA-treated healthy gingival fibroblast culture (H+CsA); and 3) healthy gingival fibroblast culture (H). The levels of MMP-1 and TIMP-1 in these groups of gingival fibroblasts were analyzed by enzyme-linked immunoabsorbent assay (ELISA). RESULTS: The levels of TIMP-1 were significantly lower in CsA GO than H (P < 0.05). There was no statistically significant difference in the levels of MMP-1 between H and CsA GO (P = 0.505). The ratio of MMP-1 to TIMP-1 was significantly higher in CsA GO than H (P < 0.05). CONCLUSIONS: The results of this study indicate that CsA therapy does not have a significant effect on MMP-1 levels. However, low TIMP-1 levels can be an important factor in the pathogenesis of CsA GO, since the balance between MMP-1 and TIMP-1 levels was changed by CsA.