Can Peri-Implant Marginal Bone Loss Progression and a-MMP-8 Be Considered Indicators of the Subsequent Onset of Peri-Implantitis? A 5-Year Study

• Published in: Diagnostics (Basel) Vol. 12; no. 11; p. 2599
• Main Authors: Guarnieri, Renzo, Reda, Rodolfo, Zanza, Alessio, Miccoli, Gabriele, Nardo, Dario Di, Testarelli, Luca
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 26.10.2022; MDPI
• Subjects: Complications and side effects; Dental implants; Development and progression; Diagnosis; Edentulous; Health aspects; implant; Implant dentures; Inflammation; Inflammatory diseases; interleukins; marginal bone loss; Metalloproteins; MMP-8; peri-implant sulcus; Periodontics; Statistical analysis; Italy; United States > US; MMP-8; implant; peri-implant sulcus; marginal bone loss; interleukins
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics12112599

The aim of this retrospective study was to investigate the relationship between the amount of early bone remodeling, the marginal bone loss (MBL) progression, and the peri-implant sulcular fluid concentration of active metalloproteinase-8 (a-MMP-8) and the incidence of peri-implantitis (P) over 5 years of implant function. It has been documented that dental implants with a high degree of early marginal bone loss (MBL) are likely to achieve additional increased MBL during function. Moreover, it has been speculated that early increased MBL might be a predictive factor for the subsequent onset of peri-implant inflammatory diseases. Clinical and radiographic data at implant placement (T0) and restoration delivery (TR) at 6 months (T1), 2 years (T2), and 5 years (T5) post-loading were retrospectively collected. MBL levels/rates (MBLr) and peri-implant sulcular fluid levels/rates of a-MMP-8 were assessed at TR, T1, T2, and T5. Implants were divided into two groups: group 1 with peri-implantitis (P+) and group 2 without peri-implantitis (P−). A multi-level simple binary logistic regression, using generalized estimation equations (GEEs), was implemented to assess the association between each independent variable and P+. A receiver operating characteristics (ROC) curve was used to evaluate an optimal cutoff point for T1 MBL degree and a-MMP-8 level to discriminate between P+ and P− implants. A total of 80 patients who had received 80 implants between them (39 implants with a laser-microtextured collar surface (LMS) and 41 implants with a machined collar surface (MS)) were included. Periapical radiographs and a software package were used to measure MBL rates. Peri-implant sulcular implant fluid samples were analyzed by a chairside mouth-rinse test (ImplantSafe®) in combination with a digital reader (ORALyzer®). Twenty-four implants (six with an LMS and eighteen with an MS) were classified as P+. No statistically significant association was found between the amount of early bone remodeling, MBL progression, and MBLr and the incidence of peri-implantitis. Implants with a-MMP-8 levels >15.3 ng/mL at T1 presented a significantly higher probability of P+. The amount of early marginal bone remodeling cannot be considered as an indicator of the subsequent onset of P, whereas high a-MMP-8 levels 6 months after loading could have a distinct ability to predict P.