Diagnosis of inflammatory peri-implant diseases using an immunochromatographic assay for calprotectin in peri-implant crevicular fluid

Abstract

Background The incidence rate of peri-implant diseases is increasing with implant placement. Early detection of peri-implant diseases is important to prevent and treat these diseases, and a simple and objective diagnostic method is expected. Immunochromatographic (IC) assays are used for rapid diagnostic methods for some diseases. The aim of this clinical study was to determine the amount of calprotectin, an inflammatory marker, in peri-implant crevicular fluid (PICF) using an IC chip, and estimate the possibility of this diagnostic system. Methods Forty-six individuals with dental implants participated in a pilot study. PICF samples were collected from the peri-implant sites with or without inflammation after clinical examinations including probing depth (PD), bleeding on probing (BOP) and gingival index (GI). Calprotectin in PICF was determined by an IC chip and enzyme-linked immunosorbent assay (ELISA) for calprotectin. The density of calprotectin line on the IC chip was measured using an IC reader (IC reader value). The relationship between IC reader value and ELISA value or clinical parameters was investigated. A receiver operating characteristic (ROC) curve analysis of IC reader value of calprotectin was performed to predict inflammation in peri-implant diseases. Results IC reader value of calprotectin was significantly correlated with its ELISA value and PD. IC reader values of calprotectin in PICF samples from periodontal sites with GI-1 and GI-2, and with BOP-positive sites were significantly higher than those of PICF samples from GI-0 sites, and BOP-negative sites, respectively. The IC reader value for calprotectin in PICF samples from inflammatory diseased sites was significantly higher than that of non-diseased sites. ROC analysis suggested that the IC reader value of PICF calprotectin was useful for predicting inflammatory peri-implant diseases. Conclusion IC assay for PICF calprotectin may be a possible system for diagnosing the inflammatory peri-implant diseases.

Soft tissue features of peri‐implant diseases and related treatment

“…A deeper knowledge of the inflammatory mechanisms, protein biomarkers, and cytokines involved in peri‐implant disease progression could be crucial for clinicians, since this can guide the early treatment through nonsurgical methods (e.g., immunomodulators and cytokine inhibitors) and surgical preventive approaches that may improve the stability of peri‐implant soft tissue structures that protect the subsequent peri‐implant crestal bone. Several studies evidenced that biomarkers for IL‐1ß, IL‐ 6, IL‐17, matrix metalloproteinases, VEGF, TNF‐α, and adipokines are significantly higher at peri‐implant diseased sites' crevicular fluid samples when compared to healthy samples 11,21,26–29 . Remarkably, certain studies have pointed that those pro‐inflammatory biomarkers are associated to thin PSP features presenting inadequate keratinized mucosa (KM) width, reduction of mucosal attachment, and higher marginal recession levels 20,21 .…”

“…Several studies evidenced that biomarkers for IL-1ß, IL-6, IL-17, matrix metalloproteinases, VEGF, TNF-α, and adipokines are significantly higher at peri-implant diseased sites' crevicular fluid samples when compared to healthy samples. 11,21,[26][27][28][29] Remarkably, certain studies have pointed that those proinflammatory biomarkers are associated to thin PSP features presenting inadequate keratinized mucosa (KM) width, reduction of mucosal attachment, and higher marginal recession levels. 20,21 Moreover, some studies have also evidenced that the pro-inflammatory biomarker expression at peri-implant diseased sites was significantly reduced by antibacterial and anti-inflammatory therapies and also after soft tissue grafting techniques that improved the PSP.…”

Oral rehabilitation with dental implants in patients with systemic sclerosis: A systematic review

“…44 These factors are the biomarkers of peri-implant inflammatory conditions. 45,46 Therefore, a high level of patient motivation, the foundation for their willingness to undergo periodic intraoral follow-up evaluations, is another requirement for long-term implant survival. Frontal linear scleroderma "en coup de sabre" in a female patient was described by Zanettini et al 31 Their findings suggest that oral reconstruction could be accomplished.…”

“…Osteoblasts’ activities can also be endorsed through enhancement in Wnt signaling, which can cause diverse bone affections as typically observed in the disease 44 . These factors are the biomarkers of peri‐implant inflammatory conditions 45,46 . Therefore, a high level of patient motivation, the foundation for their willingness to undergo periodic intraoral follow‐up evaluations, is another requirement for long‐term implant survival.…”

Calprotectin and N-telopeptide of Type I Collagen (NTx) as Gingival Crevicular Fluid (GCF) Biomarker in Peri-Implantitis Patients

“…A significant correlation was also reported by them between calprotectin IC reader value and PD. They found that BOP-positive sites had much higher levels of calprotectin than BOP-negative sites [ 27 ].…”