Peri-implantitis, Peri-implant Mucositis, Peri-Implant Health
Conditions
Keywords
Cortisol, Dehydroepiandrosterone, Depression, Anxiety, Peri-implantitis, Peri-implant sulcular fluid
Brief summary
This study examines the association between psychosocial stress and peri-implant diseases. Peri-implant diseases are inflammatory conditions affecting the tissues around dental implants and may contribute to implant failure. Stress-related hormones, including cortisol and dehydroepiandrosterone (DHEA), may influence inflammatory responses in peri-implant tissues. In this study, peri-implant sulcular fluid samples are collected from patients with peri-implant health, peri-implant mucositis, and peri-implantitis. Levels of cortisol, DHEA, and interleukin-6 (IL-6) are analyzed. Anxiety and depression levels are assessed using standardized questionnaires, and clinical peri-implant parameters are recorded. The purpose of this study is to evaluate the relationship between stress-related biomarkers, psychological status, and peri-implant health and disease.
Detailed description
Peri-implant diseases are inflammatory conditions affecting the soft and hard tissues surrounding dental implants and represent a major cause of implant failure. Psychosocial stress is known to influence immune function through activation of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in altered secretion of stress-related hormones such as cortisol and dehydroepiandrosterone (DHEA). These hormonal changes may modulate inflammatory processes in peri-implant tissues. This cross-sectional clinical study included 62 patients with dental implants, who were divided into three groups based on clinical and radiographic criteria: peri-implant health (PH, n=18), peri-implant mucositis (PM, n=22), and peri-implantitis (PI, n=22). Depression and anxiety levels were assessed using the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). Clinical peri-implant parameters, including plaque index, gingival index, bleeding on probing, probing depth, clinical attachment level, and keratinized tissue width, were recorded. Marginal bone loss was evaluated using standardized periapical radiographs. Peri-implant sulcular fluid samples were collected and analyzed for cortisol, DHEA, and interleukin-6 (IL-6) levels using enzyme-linked immunosorbent assay (ELISA). Biomarker results were expressed as both concentration and total amount. The study evaluates the associations between psychosocial stress markers, inflammatory biomarkers, and clinical peri-implant parameters to better understand the psychoneuroimmunological mechanisms involved in peri-implant diseases.
Interventions
DIAGNOSTIC_TESTPsychological Assessment
Psychological status was evaluated using the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI).
DIAGNOSTIC_TESTPeri-implant Sulcular Fluid Biomarker Analysis
Peri-implant sulcular fluid samples were collected and analyzed for cortisol, dehydroepiandrosterone (DHEA), and interleukin-6 (IL-6) levels using enzyme-linked immunosorbent assay (ELISA).
DIAGNOSTIC_TESTPeri-implant Clinical Examination
Clinical peri-implant parameters including plaque index, gingival index, bleeding on probing, probing depth, clinical attachment level, and keratinized tissue width were recorded using a periodontal probe.
DIAGNOSTIC_TESTRadiographic Assessment
Marginal bone levels around dental implants were assessed using standardized periapical radiographs.
Sponsors
Inonu University
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Being volunteer to participate in the study * Adults aged 18 to 65 years. * Systemically healthy individuals. * No periodontal treatment within the past 6 months. * No self-reported psychiatric disorders. * No use of antibiotics within the past 6 months. * No use of steroid, immunosuppressive, or psychiatric medications. * No clinically evident oral infection. * Not pregnant and not breastfeeding. * Not smoking * Maintaining oral hygiene
Exclusion criteria
* Age younger than 18 years or older than 65 years. * History of periodontal treatment within the past 6 months. * Use of antibiotics within the past 6 months. * Inadequate or contaminated peri-implant sulcular fluid samples. * Pregnancy or breastfeeding. * Long-term corticosteroid usage.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peri-implant Sulcular Fluid Cortisol Level | At baseline | Peri-implant sulcular fluid cortisol levels were measured using enzyme-linked immunosorbent assay (ELISA). Biomarker amounts were initially calculated as ng per 30 seconds of collection time and subsequently expressed as concentrations (ng/mL) for analysis and comparison among peri-implant health, peri-implant mucositis, and peri-implantitis groups. |
| Peri-implant Sulcular Fluid Interleukin-6 Level | At baseline (single assessment) | Interleukin-6 levels in peri-implant sulcular fluid were measured using enzyme-linked immunosorbent assay (ELISA). Biomarker amounts were calculated as pg per 30 seconds of collection time and subsequently expressed as concentrations (ng/mL) for analysis and comparison among peri-implant health, peri-implant mucositis, and peri-implantitis groups. |
| Peri-implant Sulcular Fluid DHEA Level | At baseline (single assessment) | Peri-implant sulcular fluid dehydroepiandrosterone (DHEA) levels were measured using enzyme-linked immunosorbent assay (ELISA). Biomarker amounts were calculated as ng per 30 seconds of collection time and subsequently expressed as concentrations (ng/mL) for analysis and comparison among peri-implant health, peri-implant mucositis, and peri-implantitis groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety Scores (State-Trait Anxiety Inventory) | At baseline (single assessment) | Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), which consists of two subscales: the State Anxiety scale (STAI-I) and the Trait Anxiety scale (STAI-II). Each subscale includes 20 items, with total scores ranging from 20 to 80. Higher scores indicate greater levels of anxiety. |
| Depression Score (Beck Depression Inventory) | At baseline | Depression levels were assessed using the Beck Depression Inventory (BDI), a 21-item self-report questionnaire. Total scores range from 0 to 63, with higher scores indicating greater severity of depressive symptoms. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORVesile E Toy, PhD
Inonu University, Department of Periodontology Faculty of Dentistry
STUDY_CHAIRFurkan Kuşoğlu, DDS
Inonu University, Department of Periodontology Faculty of Dentistry
Outcome results
None listed