BALANCING INFLAMMATION AND IMMUNE REGULATION IN PERI-IMPLANTITIS: INSIGHTS FROM THE PISF TNF-Α/IL-10 CYTOKINE RATIO



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Abstract

Background: Peri-implantitis is a severe inflammatory condition that affects both the hard and soft tissues around dental implants.  It often results in progressive bone deterioration and eventually the failure of the implant.   A crucial element in its development is the interaction between pro-inflammatory and anti-inflammatory cytokines in the local immune response.   The ratio of tumour necrosis factor-alpha (TNF-α) to interleukin-10 (IL-10) has been suggested as a potential indication of this immunological balance.

Aim: To evaluate the diagnostic relevance of the TNF-α/IL-10 ratio in peri-implant sulcus fluid (PISF) for distinguishing peri-implantitis from healthy and successfully osseointegrated implants.

Materials and Methods: In this case control study, a total of 90 participants were recruited and divided into three equal groups: healthy controls, successful implant group, and peri-implantitis group. The clinical parameters in this study included Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP) and Probing Depth (PD). PISF samples were collected from all subject and TNF-α and IL-10 concentrations were measured using enzyme-linked immunosorbent assay (ELISA).

Results: The peri-implantitis group revealed significantly elevated levels of both TNF-α and IL-10 compared to the control group and successful implants (p < 0.001).   The TNF-α/IL-10 ratio was significantly decreased in the peri-implantitis group (3.94 ± 1.22) compared to the control group (8.53 ± 1.56) and the successful implants group (7.92 ± 1.44) (p < 0.001).

Conclusion: The TNF-α/IL-10 ratio in PISF indicates the local inflammatory balance and may be an important biomarker for finding peri-implantitis.  A lower ratio, together with higher cytokine levels, indicating an anti-inflammatory response that doesn't bring the immune system back to normal.

About the authors

Ansam Zuhair Najm

Al-Iraqia University, Baghdad, Iraq

Email: ansam.z@aliraqia.edu.iq
ORCID iD: 0009-0007-3195-4092

BDS., MSc., Oral Microbiology;

Assistant Lecturer in Department of Clinical Sciences, College of Dentistry, Al-Iraqia University, Baghdad, Iraq;

Iraq

Ehab Qasim Talib

Al-Iraqia University, Baghdad, Iraq

Author for correspondence.
Email: ehab.q.t@aliraqia.edu.iq
ORCID iD: 0000-0001-8804-7302
Scopus Author ID: 58757514500
ResearcherId: https://www.researchgate.net/profile/Ehab-Talib

BSc., MSc., Oral Microbiology and Clinical immunology

Assistant Lecturer in Department of Basic Sciences, College of Dentistry, Al-Iraqia University, Baghdad, Iraq;

Iraq

References

  1. Klinge B, Klinge A, Bertl K, Stavropoulos A. Peri-implant diseases. Eur J Oral Sci. 2018 Oct;126 Suppl 1:88-94. doi: 10.1111/eos.12529.
  2. Salvi GE, Aglietta M, Eick S, Sculean A, Lang NP, Ramseier CA. Reversibility of experimental peri-implant mucositis compared with experimental gingivitis in humans. Clin Oral Implants Res. 2012 Feb;23(2):182-190. doi: 10.1111/j.1600-0501.2011.02220.x.
  3. Lee CT, Huang YW, Zhu L, Weltman R. Prevalences of peri-implantitis and peri-implant mucositis: systematic review and meta-analysis. J Dent. 2017 Jul;62:1-12 . doi: 10.1016/j.jdent.2017.04.011.
  4. Kormas I, Pedercini C, Pedercini A, Raptopoulos M, Alassy H, Wolff LF. Peri-Implant Diseases: Diagnosis, Clinical, Histological, Microbiological Characteristics and Treatment Strategies. A Narrative Review. Antibiotics (Basel). 2020 Nov 22;9(11):835. doi: 10.3390/antibiotics9110835.
  5. Persson GR, Renvert S. Cluster of bacteria associated with peri-implantitis. Clin Implant Dent Relat Res. 2014 Dec;16(6):783-93. doi: 10.1111/cid.12052.
  6. Holmqvist F, Bazsefidpay N, Khalil D, Wexell CL, Hultin M, Nilsson P, Lund B. Antibiotic utilization during bone augmentation procedures in conjunction with dental implant insertion. Int J Oral Maxillofac Surg 2019;48:45–6. https://doi.org/10.1016/j.ijom.2019.03.139.
  7. Zitzmann NU, Berglundh T, Marinello CP, Lindhe J. Experimental peri‐implant mucositis in man. J Clin Periodontol 2001;28:517–23. https://doi.org/10.1034/j.1600-051x.2001.028006517.x.
  8. Poli PP, Cicciu M, Beretta M, Maiorana C. Peri-Implant Mucositis and Peri-Implantitis: A Current Understanding of Their Diagnosis, Clinical Implications, and a Report of Treatment Using a Combined Therapy Approach. Journal of Oral Implantology 2017;43:45–50. https://doi.org/10.1563/aaid-joi-D-16-00082.
  9. Mordini L, Sun N, Chang N, De Guzman J-P, Generali L, Consolo U. Peri-Implantitis Regenerative Therapy: A Review. Biology (Basel) 2021;10:773. https://doi.org/10.3390/biology10080773.
  10. Mir‐Mari J, Mir‐Orfila P, Figueiredo R, Valmaseda‐Castellón E, Gay‐Escoda C. Prevalence of peri‐implant diseases. A cross‐sectional study based on a private practice environment. J Clin Periodontol 2012;39:490–4. https://doi.org/10.1111/j.1600-051X.2012.01872.x.
  11. Ramanauskaite A, Becker K, Schwarz F. Clinical characteristics of peri‐implant mucositis and peri‐implantitis. Clin Oral Implants Res 2018;29:551–6. https://doi.org/10.1111/clr.13152.
  12. Ferreira SD, Silva GLM, Cortelli JR, Costa JE, Costa FO. Prevalence and risk variables for peri‐implant disease in Brazilian subjects. J Clin Periodontol 2006;33:929–35. https://doi.org/10.1111/j.1600-051X.2006.01001.x.
  13. Ting M, Craig J, Balkin BE, Suzuki JB. Peri-implantitis: A Comprehensive Overview of Systematic Reviews. Journal of Oral Implantology 2018;44:225–47. https://doi.org/10.1563/aaid-joi-D-16-00122.
  14. Silness J, Löe H. Periodontal Disease in Pregnancy II. Correlation Between Oral Hygiene and Periodontal Condition. Acta Odontol Scand 1964;22:121–35. https://doi.org/10.3109/00016356408993968.
  15. Lindhe J, Meyle J. Peri‐implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008;35:282–5. https://doi.org/10.1111/j.1600-051X.2008.01283.x.
  16. Löe H, Silness J. Periodontal Disease in Pregnancy I. Prevalence and Severity. Acta Odontol Scand 1963;21:533–51. https://doi.org/10.3109/00016356309011240.
  17. Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. J Clin Periodontol. 2018 Jun;45 Suppl 20:S278-S285. doi: 10.1111/jcpe.12956. PMID: 29926496.
  18. Berglundh T, Armitage G, Araujo MG, Avila‐Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hämmerle CHF, Heitz‐Mayfield LJA, Huynh‐Ba G, Iacono V, Koo K, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang H, Zitzmann N. Peri‐implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. J Clin Periodontol 2018;45. https://doi.org/10.1111/jcpe.12957.
  19. Bhardwaj S, Prabhuji MLV. Comparative volumetric and clinical evaluation of peri-implant sulcular fluid and gingival crevicular fluid. J Periodontal Implant Sci 2013;43:233–42. https://doi.org/10.5051/jpis.2013.43.5.233.
  20. Duarte PM, De Mendonça AC, Máximo MBB, Santos VR, Bastos MF, Nociti Júnior FH. Differential cytokine expressions affect the severity of peri‐implant disease. Clin Oral Implants Res 2009;20:514–20. https://doi.org/10.1111/j.1600-0501.2008.01680.x.
  21. GOMES AM, Douglas-de-OLIVEIRA DW, FERREIRA SD, SILVA TA da, COTA LOM, COSTA FO. 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. Journal of Applied Oral Science 2019;27. https://doi.org/10.1590/1678-7757-2018-0316.
  22. Jansson L, Lundmark A, Modin C, Abadji D, Yucel‐Lindberg T. Intra‐individual cytokine profile in peri‐implantitis and periodontitis: A cross‐sectional study. Clin Oral Implants Res 2021;32:559–68. https://doi.org/10.1111/clr.13725.
  23. Bertoldo BB, Paulo GO, Furtado TC de S, Pereira TL, Rodrigues V, Rodrigues DBR, de Faria JB, Rosa RC, Pereira SA de L. New immunological aspects of peri-implantitis. Einstein (São Paulo) 2024;22. https://doi.org/10.31744/einstein_journal/2024AO0396.
  24. Speretta GF, Leite RD, Duarte ACDO. Obesidade, inflamação e exercício: foco sobre o TNF-alfa e IL-10. Revista Hospital Universitário Pedro Ernesto 2014;13. https://doi.org/10.12957/rhupe.2014.9807.
  25. Cruvinel W de M, Mesquita Júnior D, Araújo JAP, Catelan TTT, Souza AWS de, Silva NP da, Andrade LEC. Sistema imunitário: Parte I. Fundamentos da imunidade inata com ênfase nos mecanismos moleculares e celulares da resposta inflamatória. Rev Bras Reumatol 2010;50:434–47. https://doi.org/10.1590/S0482-50042010000400008.
  26. Goutoudi P, Diza E, Arvanitidou M. Effect of periodontal therapy on crevicular fluid interleukin-1β and interleukin-10 levels in chronic periodontitis. J Dent 2004;32:511–20. https://doi.org/10.1016/j.jdent.2004.04.003.
  27. Grimbaldeston MA, Nakae S, Kalesnikoff J, Tsai M, Galli SJ. Mast cell–derived interleukin 10 limits skin pathology in contact dermatitis and chronic irradiation with ultraviolet B. Nat Immunol 2007;8:1095–104. https://doi.org/10.1038/ni1503.
  28. Meng X, Grötsch B, Luo Y, Knaup KX, Wiesener MS, Chen X-X, Jantsch J, Fillatreau S, Schett G, Bozec A. Hypoxia-inducible factor-1α is a critical transcription factor for IL-10-producing B cells in autoimmune disease. Nat Commun 2018;9:251. https://doi.org/10.1038/s41467-017-02683-x.

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