Peri-implant versus periodontal wound healing

J Clin Periodontol. 2013 Aug;40(8):816-24. doi: 10.1111/jcpe.12127. Epub 2013 Jun 18.

Abstract

Aim: Peri-implant gingival healing following one-stage implant placement was investigated and compared to periodontal healing.

Methods: Healing at surgical sites [implant (I) and adjacent teeth (T+)] was compared to non-operated tooth (T-) in non-smokers receiving one-stage implant. Periodontal Indices (PI, GI) were recorded at surgery and up to 12 weeks post-operatively. Peri-implant (PICF) and gingival crevicular fluids (GCF) were analysed for cytokines, collagenases and inhibitors. Data were analysed by linear mixed model regression analysis and repeated measures anova.

Results: Forty patients (22 females; 21-74 years old) completed the study. Surgical site GI, increased at week 1, decreased significantly during early healing (weeks 1-3; p = 0.0003) and continually decreased during late healing (weeks 6-12) for I (p < 0.01). PICF volume decreased threefold by week 12 (p = 0.0003). IL-6, IL-8, MIP-1β and TIMP-1 levels significantly increased at surgical sites at week one, significantly decreasing thereafter (p < 0.016). Week one IL-6, IL-8 and MIP-1β levels were ~threefold higher and TIMP-1 levels 63% higher, at I compared to T+ (p = 0.001).

Conclusion: Peri-implant gingival healing, as determined by crevicular fluid molecular composition, differs from periodontal healing. The observed differences suggest that peri-implant tissues, compared to periodontal tissues, represent a higher pro-inflammatory state.

Keywords: crevicular fluid; cytokines; dental implant; gingiva; periodontal surgery; wound healing.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chemokine CCL4 / analysis
  • Cohort Studies
  • Dental Implants*
  • Female
  • Follow-Up Studies
  • Gingiva / pathology*
  • Gingiva / surgery
  • Gingival Crevicular Fluid / chemistry
  • Humans
  • Interleukin-6 / analysis
  • Interleukin-8 / analysis
  • Male
  • Matrix Metalloproteinase 8
  • Matrix Metalloproteinase 9
  • Matrix Metalloproteinase Inhibitors / analysis
  • Middle Aged
  • Periodontal Index
  • Periodontium / pathology*
  • Periodontium / surgery
  • Prospective Studies
  • Surgical Flaps / pathology
  • Tissue Inhibitor of Metalloproteinase-1 / analysis
  • Tissue Inhibitor of Metalloproteinase-2
  • Vascular Endothelial Growth Factor A / analysis
  • Wound Healing / physiology
  • Young Adult

Substances

  • CCL4 protein, human
  • CXCL8 protein, human
  • Chemokine CCL4
  • Dental Implants
  • IL6 protein, human
  • Interleukin-6
  • Interleukin-8
  • Matrix Metalloproteinase Inhibitors
  • TIMP1 protein, human
  • TIMP2 protein, human
  • Tissue Inhibitor of Metalloproteinase-1
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Tissue Inhibitor of Metalloproteinase-2
  • MMP8 protein, human
  • Matrix Metalloproteinase 8
  • MMP9 protein, human
  • Matrix Metalloproteinase 9