3.22.23 The 4 postdocs_Peri-implantitis microbiota

Question 1

What is the current definition of peri-implantitis?

Answer 1

Renvert ‘18 (AAP consensus)
Peri-implantitis is defined in the presence of baseline data as having:
* BOP/suppuration (gentle probing)
* Increased PD (compared to previous exams)
* Radiographic bone loss beyond initial remodeling

If Baseline data Absent:
* BOP and/or SUP with PD ≥ 6 mm and BL ≥ 3 mm.

Question 2

What are the 7 most disease-related species in peri-implantitis? How does peri-implantitis differ from periodontitis?

Answer 2

Ghensi ‘20
* P. gingivalis
* P. endodontalis
* T. forsythia
* F. nucleatum
* Fretibacterium fastidiosum
* P. intermedia
* T. denticola

Laufarie et al. 2017
P. gingivalis was present in both.
P. Intermedia and T. forsythia were more frequent in periodontitis vs. peri- implantitis

Peri-implantitis showed opportunistic pathogens which were not commonly seen in periodontitis:
* Pseudomonas aeruginosa
* Candida albicans
* Enteric rods
* Staphylococcus aureus

Question 3

What are the intraoral sources of biomarkers?

Answer 3

Alassy ‘19
Gingival crevicular fluid
Peri-implant crevicular fluid
Saliva

Question 4

How does peri-implant sulcular fluid flow rate correlate to MMP levels?

Answer 4

Janksa ‘16

PISF MMP8 levels < 8 ng/ml: identified healthy peri-implant sites,
levels between 8 and 20 ng/ml PIM,
And levels > 20 ng/ml a more or less progressive PI

a significant correlation between the samples from superficial and fundus area in both M & D sides. However, in 83.3 % of the cases, samples from the fundus area reached higher values of MMP8
level.

Zani ‘16
Implants with PI had sig. higher levels of 12/20 biomarkers compared to H implants.

Ghassib ‘19
Systematic review
19 articles in meta-analysis
Significant increase in IL-6 is shown between MU and PI while IL-1β levels did not increase as remarkably.

Pro-inflammatory cytokines in PICF can be used as adjunct tools to clinical parameters to differentiate Health from Mucositis (MU) and Periimplantitis (PI).

Rakic ‘19
Personalized diagnostic model for implant diagnostics based on clinical parameters and bone markers

The algorithms identified RANKL levels < 19 pg/site as discriminant between PIMP and second excessive cluster of PIM

Question 5

Are there genetic factors of peri-implantitis?

Answer 5

Schwarz 2018
* Interleukin-1 (IL-1) is a pro-inflammatory cytokine that is associated with bone resorption.
* TNF-alpha: Pro-inflammatory cytokine that is associated with bone resorption.
* MMP-1: Enzyme that degrades collagen, a major component of the extracellular matrix in the periodontium.
* VDR: The vitamin D receptor (VDR) gene is involved in regulating bone metabolism.
* TLR-4: Innate immune response to bacterial infection. Polymorphisms in the TLR-4 gene have been linked to increased susceptibility to periodontitis and periimplantitis.