Neurogenic inflammation in periimplant and periodontal disease: A case–control split‐mouth study

Abstract

Objective: Although the regulatory effects of substance-P (SP), neurokinin-A (NKA), calcitonin gene-linked peptide (CGRP) and neuropeptide-Y (NPY) on periodontal inflammatory responses have been described, the effects of these neuropeptides on healthy and diseased periimplant tissues are not clearly defined. Materials and methods:Thirty-nine implants loaded at least for 12 months with their symmetrically matching teeth were evaluated and compared by a split-mouth study design. Six study groups were created in this regard as follows: group 1 (healthy periodontal tissues), group 2 (healthy periimplant tissues), group 3 (gingivitis), group 4 (periimplant mucositis), group 5 (periodontitis) and group 6 (periimplantitis). Clinical examinations included Silness-Löe plaque index, Löe-Silness gingival index, bleeding on probing, probing pocket depth and clinical attachment level measurements. Gingival crevicular fluid and periimplant sulcular fluid samples were collected, and the concentrations of neuropeptides were determined by enzyme-linked immunosorbent assay. Their levels and correlations were investigated together with the clinical parameters.Results: Neuropeptide levels were different in the teeth and implant groups according to the periodontal status (p < 0.001). SP and NKA levels were increased, whereas CGRP and NPY levels were decreased in the diseased states. There were no differences between the neuropeptide levels of matching teeth and implants (groups 1-2, groups 3-4 and groups 5-6; p > 0.05). Conclusion:Our study demonstrated the presence of local neuropeptides in healthy and diseased periimplant tissues. The neurogenic inflammatory responses were also found to be similar in both periimplant and periodontal tissues. K E Y W O R D Sgingivitis, inflammation, neuropeptides, periimplantitis, periodontitis | 801 SERT ET al.

Establishing the Role of Neurogenic Inflammation in the Pathogenesis of Periodontitis: A Systematic Review

“…Studies have shown that smokers with periodontitis had higher SP in the gingival biopsy sample than smokers with periodontally healthy teeth, nonsmokers with periodontitis, and nonsmokers with periodontally healthy teeth [23]. Sert et al had seen similar findings where SP levels were higher in the diseased state than in healthy periodontium [25]. In a cross-sectional study, Hanioka et al found that SP was significantly correlated to probing pocket depth (r=0.637, p≤.001), therefore, SP could be a key element in GCF [31].…”

“…Outlines of the available studies are presented in Table 3 [ 19 - 25 ], Table 4 [ 26 - 28 ], Table 5 [ 29 - 30 ], and Table 6 [ 31 - 32 ]. Several studies analyzed the relationship between periodontal disease and more than one neuropeptide.…”

“…A notable increase in CGRP immunoreactivity was detected in periodontally healthy patients compared to those with gingivitis and periodontitis-affected sites [ 21 ]. Sert et al demonstrated that CGRP levels decreased in diseased states [ 25 ]. CGRP levels in healthy periodontal tissues were 48.99 ± 0.78 pg/µL 30 s, whereas, in diseased states, they decreased to 23.93 ± 1.80 pg/µL 30s.…”

“…Linden et al showed a significant increase in NKA in periodontitis-affected subjects compared to healthy controls [ 31 ]. However, Sert et al reported that NKA levels decreased in diseased states [ 25 ]. NKA levels in healthy periodontal tissues were 583.11 ± 13.58 pg/µL 30 s but decreased to 108.33 ± 18.31 pg/µL 30s in disease states.…”

“…Elevated NPY levels are present in the GCF of healthy tissues (161 ng) compared to periodontitis-affected tissues (39.8 ng). Sert et al found that NPY levels decreased in diseased states [ 25 ].…”