Periodontal disease, peri-implant disease and levels of salivary biomarkers IL-1β, IL-10, RANK, OPG, MMP-2, TGF-β and TNF-α: follow-up over 5 years

Abstract Objective The aim of this study was to evaluate the levels of salivary biomarkers IL-1β, IL-10, RANK, OPG, MMP-2, TG-β and TNF-α in individuals with diagnosis of peri-implant mucositis in the absence or presence of periodontal and peri-implant maintenance therapy (TMPP) over 5 years. Material and Methods Eighty individuals diagnosed with peri-implant mucositis were divided into two groups: one group that underwent periodontal and peri-implant regularly maintenance therapy, called GTP (n=39), and a second group that received no regular maintenance GNTP (n=41). Each participant underwent a complete periodontal and peri-implant clinical examination. Collection of saliva samples and radiographic examination to evaluate peri-implant bone levels were conducted at two times: initial examination (T1) and after 5 years (T2). The salivary samples were evaluated through ELISA for the following markers: IL-1β, IL-10, RANK, OPG, MMP-2, TGF and TNF-α. Results A higher incidence of peri-implantitis was observed in the GNTP group (43.9%) than in the GTP group (18%) (p=0.000). All individuals (n=12) who presented peri-implant mucositis and had resolution at T2 were in the GTP group. After 5 years, there was an increase in the incidence of periodontitis in the GNTP group compared to the GTP group (p=0.001). The results of the study revealed an increase in the salivary concentration of TNF-α in the GNTP group compared to the GTP group. The other salivary biomarkers that were evaluated did not show statistically significant differences between the two groups. Conclusions The salivary concentration of TNF-α was increased in individuals with worse periodontal and peri-implant clinical condition and in those with a higher incidence of peri-implantitis, especially in the GNTP group. Longitudinal studies in larger populations are needed to confirm these findings and elucidate the role of this biomarker in peri-implant disease.

摘要 研究目的
本研究旨在评估接受或未接受5年牙周及种植体周围维护治疗（periodontal and peri-implant maintenance therapy, TMPP）的确诊种植体周围黏膜炎患者的唾液生物标志物水平，涉及的标志物包括白细胞介素1β（IL-1β）、白细胞介素10（IL-10）、核因子κB受体活化因子（RANK）、骨保护素（OPG）、基质金属蛋白酶2（MMP-2）、转化生长因子β（TGF-β）及肿瘤坏死因子α（TNF-α）。

材料与方法
招募80名确诊为种植体周围黏膜炎的受试者，分为两组：一组接受规律牙周及种植体周围维护治疗，设为GTP组（n=39）；另一组未接受规律维护治疗，设为GNTP组（n=41）。所有受试者均接受完整的牙周及种植体周围临床检查。分别于基线检查（T1）及5年后随访（T2）两个时间点采集唾液样本，并通过影像学检查评估种植体周围骨水平。采用酶联免疫吸附试验（ELISA）对唾液样本中的上述标志物进行检测：IL-1β、IL-10、RANK、OPG、MMP-2、TGF-β及TNF-α。

结果
GNTP组种植体周围炎的发生率（43.9%）显著高于GTP组（18%）（p=0.000）。所有在T2随访时种植体周围黏膜炎得到缓解的12名受试者均来自GTP组。随访5年后，GNTP组牙周炎的发生率较GTP组显著升高（p=0.001）。本研究结果显示，GNTP组唾液中TNF-α浓度显著高于GTP组。其余检测的唾液生物标志物在两组间均未呈现统计学显著差异。

结论
牙周及种植体周围临床状况更差、种植体周围炎发生率更高的受试者（尤其是GNTP组），其唾液TNF-α浓度显著升高。未来需开展更大样本量的纵向研究以验证本研究结果，并阐明该生物标志物在种植体周围疾病中的作用。