Periimplant Diseases, Periodontal Diseases
Conditions
Keywords
Periodontal Diseases, periimplant diseases, Oxidative Stress, Alveolar Bone Loss
Brief summary
The aim of this study is to evaluate and compare the levels of bone resorption (RANKL, OPG) and oxidative stress (Nitrotyrosine, NQO1) markers, along with pro-inflammatory cytokines (IL-1β), in the saliva and peri-implant sulcular fluid (PISF) of patients with peri-implantitis, periodontitis, and healthy individuals. The study seeks to determine the diagnostic value of these biomarkers in the early detection and progression of peri-implant diseases.
Detailed description
Patients applying to the University of Health Sciences, Gulhane Faculty of Dentistry, Department of Periodontology, will be screened according to the inclusion and exclusion criteria. Following clinical and radiographic examinations, participants will be categorized into four groups (n=20 per group): Periodontitis, Peri-implantitis, Periodontal Health, and Peri-implant Health. All clinical parameters, including Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), Probing Depth (PD), and Clinical Attachment Loss (CAL), will be recorded at six sites per tooth/implant using a Williams periodontal probe. The biological sample collection protocol will be conducted as follows: Saliva Collection: To minimize circadian rhythm variations, unstimulated whole saliva samples (3 ml) will be collected between 9:00 AM and 10:00 AM. Patients will be instructed to refrain from eating, drinking, or oral hygiene procedures for at least one hour prior to collection. Samples will be centrifuged at 1,000g for 10 minutes to remove cellular debris, and the supernatant will be stored at -80°C until laboratory analysis. Peri-implant Sulcular Fluid (PISF) and Gingival Crevicular Fluid (GCF) Collection: Samples will be obtained from the site with the deepest probing depth in each participant. The area will be isolated with cotton rolls and gently dried with an air syringe to prevent salivary contamination. Periopaper strips will be inserted into the sulcus/pocket for 30 seconds. Strips contaminated with blood or visible saliva will be discarded. Laboratory Analysis: The concentrations of Interleukin-1 beta (IL-1β), Nitrotyrosine, Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL), Osteoprotegerin (OPG), and NAD(P)H: Quinone Oxidoreductase 1 (NQO1) will be quantified in both saliva and PISF/GCF samples using commercially available Enzyme-Linked Immunosorbent Assay (ELISA) kits according to the manufacturer's instructions.
Interventions
None listed
Sponsors
Saglik Bilimleri Universitesi
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
Systemically healthy volunteers aged 18-65. For Peri-implantitis group: Implants in function for ≥1 year, radiographic bone loss ≥ 2 mm, probing depth (PD) ≥ 5 mm, and presence of bleeding on probing (BOP) or suppuration. For Periodontitis group: At least one tooth with PD ≥ 4 mm, presence of BOP, and radiographic bone loss.For Healthy groups: PD ≤ 3 mm, no clinical inflammation (BOP-), and no radiographic bone loss. (According to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases) -
Exclusion criteria
Presence of systemic diseases (e.g., diabetes, rheumatoid arthritis, osteoporosis). Use of antibiotics, anti-inflammatory, or immunosuppressive drugs within the last 3 months. Pregnancy or breastfeeding. Smoking (current smokers). History of periodontal or peri-implant surgical treatment within the last 6 months. Implant failure (mobility). Signs of acute infection (fever, systemic symptoms). \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Salivary and Peri-implant Sulcular Fluid (PISF) IL-1β Levels. | At the baseline clinical examination (Day 0). | The concentration of Interleukin-1 beta (IL-1β), a pro-inflammatory cytokine, will be measured in picograms per milliliter (pg/mL) using ELISA kits to evaluate the severity of inflammation and bone destruction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Salivary and Peri-implant Sulcular Fluid (PISF) Nitrotyrosine Levels | Baseline (at the time of clinical examination) | Concentration of Nitrotyrosine will be measured in saliva and PISF samples using ELISA kits. Nitrotyrosine serves as a biochemical marker of nitrosative stress to evaluate oxidative damage. |
| Salivary and Peri-implant Sulcular Fluid (PISF) NQO1 Levels | Baseline (at the time of clinical examination) | NAD(P)H: Quinone Oxidoreductase 1 (NQO1) levels will be measured using ELISA kits to assess the local and systemic antioxidant defense response. |
| Salivary and Peri-implant Sulcular Fluid (PISF) RANKL Levels | Baseline (at the time of clinical examination) | Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL) levels will be measured to evaluate osteoclast activation and bone destruction potential. |
| Salivary and Peri-implant Sulcular Fluid (PISF) OPG Levels | Baseline (at the time of clinical examination) | Osteoprotegerin (OPG) levels will be measured. OPG acts as a decoy receptor for RANKL, and its level indicates the body's attempt to inhibit bone resorption. |
| Clinical Attachment Loss (CAL) and Probing Depth (PD) | Baseline (at the time of clinical examination) | CAL and PD will be measured in millimeters (mm) at six sites per tooth/implant using a Williams periodontal probe to assess the severity of tissue destruction. |
| Plaque Index (PI) and Gingival Index (GI) | Baseline (at the time of clinical examination) | PI and GI will be recorded using Silness-Löe and Löe-Silness indices (scored 0-3) to evaluate oral hygiene status and gingival inflammation. |
Countries
Turkey (Türkiye)
Contacts
CONTACTNurullah Yurdakul, Dr.
PRINCIPAL_INVESTIGATORGülbahar Ustaoğlu, Professor
University of Health Sciences, Gulhane Faculty of Dentistry, Department of Periodontology
Outcome results
None listed