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The lack of keratinized mucosa is associated with poor peri-implant tissue health: a cross-sectional study.

ABSTRACT: OBJECTIVES:The aim of this cross-sectional study is to determine the association between the absence of keratinized mucosa and peri-implant tissue health. METHODS AND MATERIALS:This cross-sectional study comprised 412 implants from 200 patients from faculty-based clinics. Demographic, medical, and clinical information were collected. The modified sulcus bleeding index, modified plaque index, mucosal recession, probing depth, bone level, the width of keratinized mucosa, and implant status were evaluated by three calibrated examiners. Each implant was categorized into either of two peri-implant mucosa groups: keratinized mucosa (KM) or non-keratinized mucosa (NKM). The chi-square test was performed to the association between the keratinized mucosa groups and peri-implant clinical parameters and peri-implant status. Multiple logistic regression models were analyzed to test potential associations between peri-implant clinical parameters and the presence or absence of keratinized mucosa. RESULTS:Thirty-two implants (7.8%) were categorized into the NKM group. The prevalence of peri-implantitis was 12.5% and 8.3% at the subject level and implant level, respectively. The NKM group was associated with more plaque accumulation, mucosal recession, interproximal bone level ? 3?mm, and peri-implantitis (p < 0.05). After controlling for confounding factors, the NKM group demonstrated higher plaque accumulation, mucosal recession, and interproximal bone level ? 3?mm with adjusted odds ratios of 2.98 (1.33-6.66), 3.20 (95% CI, 1.03-9.90), and 4.62 (1.70-12.58), respectively. CONCLUSION:Within the limitation of this study, the lack of keratinized mucosa around the dental implants was significantly associated with more plaque accumulation, mucosal recession, interproximal bone level ? 3?mm, and peri-implantitis.

SUBMITTER: Kungsadalpipob K

PROVIDER: S-EPMC7363759 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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The lack of keratinized mucosa is associated with poor peri-implant tissue health: a cross-sectional study.

Kungsadalpipob Kajorn K Supanimitkul Kakanang K Manopattanasoontorn Sukuma S Sophon Navawan N Tangsathian Teerawut T Arunyanak Sirikarn P SP

International journal of implant dentistry 20200716 1

<h4>Objectives</h4>The aim of this cross-sectional study is to determine the association between the absence of keratinized mucosa and peri-implant tissue health.<h4>Methods and materials</h4>This cross-sectional study comprised 412 implants from 200 patients from faculty-based clinics. Demographic, medical, and clinical information were collected. The modified sulcus bleeding index, modified plaque index, mucosal recession, probing depth, bone level, the width of keratinized mucosa, and implant ...[more]

PMID: 32671594

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Project description:Oral health is associated with a symbiotic microbial community and host-microbe homeostasis is maintained by the controlled immune response. Various factors can disrupt this homeostasis. Dysbiosis, which is characterized by increased immune response and a shift in the microbiome, contributes the pathogenesis of peri-implantitis. Peri-implant mucosa and commensal bacteria play important roles in the maintenance of host-microbe homeostasis, but little is known about how they interact. We have therefore investigated the early host-microbe interaction between a commensal multispecies biofilm (Streptococcus oralis, Actinomyces naeslundii, Veillonella dispar, Porphyromonas gingivalis) and peri-implant mucosa at 24 and 48 h. Our in vitro peri-implant mucosa-biofilm model contained organotypic oral mucosa, implant material and biofilm. After 24 h, the biofilm induced a modest innate immune response in the peri-implant mucosa by the upregulation of 5 genes related to immune and inflammatory response and the increased secretion of IL-6 and CCL20. This controlled immune response protected tissue integrity and the peri-implant mucosa remained intact. The secreted antibacterial proteins human β-Defensins-1, -2, and CCL20 controlled the overgrowth of the biofilm by reducing its volume - without affecting the live/dead ratio or bacterial distribution. Thus, host-microbe homeostasis was established within the first 24 h. In contrast, host-microbe homeostasis was disrupted after 48 h. The mucosa was damaged and detached from the implant, due to the induced downregulation of cell adhesion related genes. The immune response was enhanced by upregulation of additional genes related to the immune and inflammatory response and increased secretion of IL-1β, TNF-α, and CCL20. Moreover, bacterial distribution was altered, with an increased proportion of V. dispar. The disrupted host-microbe homeostasis could lead to incipient dysbiosis. This deeper understanding of the early host-microbe interaction at the peri-implant site may provide the basis for new strategies to improve the prevention and therapy of peri-implant diseases.

Dataset Information

The lack of keratinized mucosa is associated with poor peri-implant tissue health: a cross-sectional study.

Publications

The lack of keratinized mucosa is associated with poor peri-implant tissue health: a cross-sectional study.

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