Experimental mucositis and experimental gingivitis in persons aged 70 or over. Clinical and biological responses

Abstract

ObjectivesTo compare in persons aged 70 years or older the clinical and inflammatory changes occurring around implants and natural teeth during and after a phase of undisturbed plaque accumulation.Material and methodsTwenty partially edentulous participants with titanium implants refrained from oral hygiene practices while being clinically monitored in weekly intervals for 21 days. Teeth and implants were then cleaned, oral hygiene resumed, and the participants were further monitored for 3 weeks. Twelve biomarkers were assessed in gingival and peri‐implant crevicular fluid (GCF, PCF).ResultsDuring 3 weeks of oral hygiene abstention, the gingival index (GI) continuously increased. On day 21, there were significantly more sites with GI >1 at implants than at teeth. After restarting oral hygiene, the GI decreased markedly in both groups. Throughout the experiment, the plaque index was significantly higher on teeth than on implants.The different biomarkers reacted variably. IL‐1β increased significantly with plaque accumulation. IL‐1β, GM‐CSF, TNF‐α, and IFN‐γ were significantly higher in GCF compared to PCF at day 21. IL‐8 decreased significantly in GCF up to day 14. MIP‐1β decreased significantly in GCF, but not in PCF. At the 3‐week follow‐up, the levels of all biomarkers assessed in GCF and PCF had returned to baseline values.ConclusionsIn an elderly cohort, plaque accumulation induced an inflammatory reaction around both teeth and implants. Although there was less plaque accumulation on implants, the peri‐implant mucosa showed a stronger clinical response than gingiva.

Peri‐implant mucositis

“…This indicated that resolution of experimental peri‐implant mucositis in humans may take longer than 3 weeks (Table ). In contrast to the study by Salvi et al., all clinical parameters assessed in an elderly patient sample (i.e., ≥70 years) returned to pre‐experimental levels after 3 weeks of reinstituted biofilm control, thus documenting reversibility of experimentally induced peri‐implant mucositis …”

“…Resolution of host biomarkers in peri‐implant crevicular fluid following 21 days of reinstituted biofilm control…”

“…Peri‐implant mucositis develops from healthy peri‐implant mucosa following accumulation of bacterial biofilms around osseointegrated dental implants. A cause‐and‐effect relationship between experimental accumulation of bacterial biofilms around titanium dental implants and the development of an inflammatory response (i.e., experimental peri‐implant mucositis) has been demonstrated in humans …”

“…A recent study, by Meyer et al., compared clinical and biologic responses during experimental gingivitis and peri‐implant mucositis in subjects aged ≥70 years. Although less biofilm accumulation was observed at implant sites, the peri‐implant mucosa yielded a higher proportion of bleeding sites compared with that observed in the gingiva, thus confirming the results by Salvi et al . obtained in a younger patient sample.…”

What is the impact of titanium particles and biocorrosion on implant survival and complications? A critical review

“…Premature loading, tobacco smoking, and systemic conditions such as diabetes have been associated with early implant loss (De Bruyn & Collaert, 1994;Mombelli & Cionca, 2006). Clinical experiments (Meyer et al, 2017;Pontoriero et al, 1994;Salvi et al, 2012;Zitzmann, Berglundh, Marinello, & Lindhe, 2001) have established a causeeffect relationship between biofilm formation and inflammation, with a stronger clinical reaction around implants compared to teeth. Factors associated with peri-implantitis and late failures include periodontitis, smoking, and diabetes mellitus (Atieh, Alsabeeha, Faggion, & Duncan, 2013;Bornstein, Cionca, & Mombelli, 2009;Derks & Tomasi, 2015;Heitz-Mayfield & Huynh-Ba, 2009;Karoussis, Kotsovilis, & Fourmousis, 2007;Klokkevold & Han, 2007;Ong et al, 2008;Quirynen, Abarca, Van Assche, Nevins & van Steenberghe, 2007;Safii, Palmer, & Wilson, 2010;Schou, Holmstrup, Worthington, & Esposito, 2006;Stacchi et al, 2016).…”