Morphological and immunophenotypical differences between chronic periodontitis and peri-implantitis - a cross-sectional study.

PURPOSE: To examine differences in morphology and in immunophenotype subsets between chronic periodontitis (CP) and peri-implantitis (P-I) lesions and to test the diagnostic agreement (CP vs P-I) among three independent observers, based on histopathological features. MATERIALS AND METHODS: This observational cross-sectional study included 15 gingival biopsies of CP lesions and 15 biopsies of P-I lesions for double-blinded examination by three independent pathologists. Inflammatory infiltrate intensity was assessed semiquantitatively on a 4-point scale, determining the percentage of lymphocytes, plasma cells, monocytes/macrophages, and granulocytes and the presence/absence of bacterial colonies. Immunohistochemical analyses were performed to verify the inflammatory infiltrate subset data (CD45, CD38, CD68 and myeloperoxidase [MPO]-positive), and number of vessels. Kappa statistic was used to evaluate the degree of diagnostic concordance among examiners. RESULTS: Inflammatory infiltrate was significantly more severe in P-I cases (P = 0.01), which showed a significantly higher percentage of plasma cells (P = 0.004) than in CP cases. Immunohistochemically, the percentage of leukocyte subsets was generally lower in CP (CD38: 32.05%; CD68: 6.45% and MPO: 8.62%) than in P-I (CD38: 61.13%; CD68: 9.09% and MPO: 7.47%) (CD38 P = 0.001, P = 0.955 and P = 0.463, for remaining subsets, respectively; Mann-Whitney U-test). The inter-observer diagnostic agreement was poor or slight (kappa = -0.18 to 0.13). CONCLUSIONS: Despite the significantly more severe general inflammatory infiltrate and plasma cells in P-I cases, it proved difficult to detect reliable differential morphological features based on histopathological images of these CP and P-I soft-tissue samples, obtaining low inter-observer and intra-observer diagnostic agreement. Conflict of interest statement: This investigation was partially supported by Research Groups #CTS-138 and #CTS-583 (Junta de Andalucía, Spain). No conflict of interest.

Microbial Profiles and Detection Techniques in Peri-Implant Diseases: a Systematic Review.

OBJECTIVES: To describe the microbial profiles of peri-implant diseases and the main detection methods. MATERIAL AND METHODS: A literature search was performed in MEDLINE via PubMed database to identify studies on microbial composition of peri-implant surfaces in humans published in the last 5 years. Studies had to have clear implant status definition for health, peri-implant mucositis and/or peri-implantitis and specifically study microbial composition of the peri-implant sulcus. RESULTS: A total of 194 studies were screened and 47 included. Peri-implant sites are reported to be different microbial ecosystems compared to periodontal sites. However, differences between periodontal and peri-implant health and disease are not consistent across all studies, possibly due to the bias introduced by the microbial detection technique. New methods non species-oriented are being used to find 'unexpected' microbiota not previously described in these scenarios. CONCLUSIONS: Microbial profile of peri-implant diseases usually includes classic periodontopathogens. However, correlation between studies is difficult, particularly because of the use of different detection methods. New metagenomic techniques should be promoted for future studies to avoid detection bias.

The 1st Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2016. Summary and Consensus Statements: Group II - Peri-Implantitis Diagnostics and Decision Tree.

INTRODUCTION: The task of Group 2 was to review and update the existing data concerning clinical and genetic methods of diagnostics of peri-implantitis. Special interest was paid to the peri-implant crevicular fluid (PICF) overview including analysis of enzymes and biomarkers and microbial profiles from implants. MATERIAL AND METHODS: The main areas of interest were as follows: effect of smoking and history of periodontitis, prosthetic treatment mistakes, excess cement, overloading, general diseases influence on peri-implantitis development. The systematic review and/or meta-analysis were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. The literature in the corresponding areas of interest was searched and reported using the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. The method of preparation of systematic reviews of the literature based on comprehensive search strategies was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic review and/or meta-analysis is presented in Preface chapter. RESULTS: The results and conclusions of the review process are presented in the respective papers. The group's general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article.