Alkaline phoshatase, tumor necrosis factor-alpha and matrix metalloproteinase-8 in crevicular fluid from peri-implantitis versus chronic periodontitis patients

ABSTRACT

Peri-implantitis is an inflammatory reaction affecting the tissues surrounding osseointegrated dental implants resulting in loss of supporting bone. Recent advances in the understanding of biologic events involved in the pothogenesis of periodontitis indicating that bone mediators e.g. tumor necrosis factor-alpha [TNF-alpha], alkaline phosphatase [ALP] and matrix metalloproteinase-8 [MMP-8] may also be operating in the pathogenesis of peri-implantitis. This study aimed to explore whether pro-inflammatory mediator TNF-alpha and markers of bone loss; ALP and MMP-8 in per-implant crevicular fluid [PICF] provide a diagnostic information as to the status of the implant. The present study evaluated 11 implants in patients having peri-implantitis and 12 without implantitis as compared to 12 patients with chronic periodontitis. The clinical assessment for all patient groups included pocket depth [PD], plaque index [PI] and gingival index [GI]. There were significant differences [p<0.05] in PI, PD and GI in peri-implantitis and periodontitis patient groups as compared to healthy implant group, while there were non significant difference between per-implantitis and periodontitis patient groups. ALP, MMP-8 and TNF-alpha were measured in gingival crevicular fluid [GCF] and PICF 2 years postoperatively. The ALP activity and MMP-8 concentration were significantly higher in periodontitis and peri-implantitis patients than healthy implant group [p<0.01, and p<0.05, respectively]. There were no statistically significant differences TNF-alpha concentration between the three study groups. There were no statistically significant differences in MMP-8 concentration and ALP activity between periodontitis group and patients with per-implantitis. The ALP activity showed a significant positive correlation with GI and PD [p<0.01]. In conclusion, the present results might suggest that ALP and MMP-8 in PICF has a possible role as a markers of peri-implantitis