Comparison of pro‐inflammatory cytokines and bone metabolism mediators around titanium and zirconia dental implant abutments following a minimum of 6 months of clinical function

Abstract

Objectives Dental implant abutments are fundamental prosthetic components within dentistry that require optimal biocompatibility. The primary aim of this cross-sectional study was to preliminarily assess differences in the pro-inflammatory cytokine and bone metabolism mediator protein expression in the peri-implant crevicular fluid adjacent to transmucosal abutments. Material and Methods Abutments were fabricated from either titanium or zirconia in patients previously receiving single-tooth implant therapy. All subjects sampled in this study had an identical implant system and implant-abutment connection. Participants (n=46) had an average time of clinical function for 22 months (6.2–72.8 months, ±SD 17.0 months) and received a clinical and radiographic exam of the implant site at the time of peri-implant crevicular fluid (PICF) sampling using a paper strip-based sampling technique. Cytokine, chemokine, and bone metabolism mediator quantities (picograms/30 s) were determined using a commercial 22-multiplexed fluorescent bead-based immunoassay instrument. A total of 19 pro-inflammatory cytokines and 7 bone metabolism mediators were evaluated. Results Multivariable analyses provided no evidence of a group (titanium or zirconia), gender, or age effect with regard to the expression of pro-inflammatory mediators evaluated. Significant (p=0.022) differences were observed for the bone-mediator leptin, with titanium abutments demonstrating significantly elevated levels in comparison to zirconia. Osteopontin demonstrated a significant (p=0.0044) correlation with age of the subjects. Conclusions No significant differences in pro-inflammatory cytokine or bone metabolism mediator profiles were observed biochemically, with the exception of leptin, for the abutment biomaterials of titanium or zirconia The molecular PICF findings support the observed clinical biocompatibility of both titanium and zirconia abutments.

Comparison of Proinflammatory Cytokine Levels in Gingival Crevicular Fluid around Dental Implants with Ceramic and Titanium Abutments

“…The molecular findings of GCF around implants, too, showed that both abutments were clinically biocompatible. 20 It should be pointed out that in that study of the cytokines evaluated, similar to that in the present study, the concentrations of IL-1β and IL-6 around titanium implants were significantly higher than those around ceramic abutments. In another study, too, long-term comparison of cytokines in the fluids and GCF around implants showed that the concentrations of IL-6, IL-4, IL-10, tumor necrosis factor-α, and interferon-δ in the GCF around implants and teeth were not significantly different, with no significant changes over time.…”

A Comparison of Zirconia and Titanium Abutments for Microleakage

“…Similarly, long‐term biocompatibility of the implant materials requires further research especially in relation to dental implants. Although some recent work report no difference in how soft tissue response to abutments made in Ti and in Zi, fatigue, wear, and related microleakage may negatively affect tissue integrity and health.…”

“…In addition, these abutments are generally placed with closing torque values lower than what manufacturer recommends due to high risk of abutment fracture . Currently, there is very limited data available on possible microleakage problems related to Zi abutments although the clinical biocompatibility, measured through peri‐implant crevicular fluid content following 6 months of loading, was reported as similar to titanium (Ti) abutments . Thus, the purpose of this study was to investigate microleakage through the implant‐abutment interface using the same implant fixture with two different abutments of the same design.…”

Long‐Term Survival and Peri‐Implant Health of Titanium Implants with Zirconia Abutments: A Systematic Review and Meta‐Analysis

“…In contrast, a recent study showed zirconia abutments presented a smaller microgap . Also, no significant difference was observed between zirconia and titanium abutments in the amount of oral pathological bacteria, pro‐inflammatory cytokine, and bone metabolism mediator profiles …”