Effects of Tumor Necrosis Factor-Alpha Level in Peri-implanter Sulcular Fluid on Alveolar Bone Loss: A Prospective Study

Year 2025, Volume: 35 Issue: 3, 201 - 206, 24.07.2025

Gülüçağ Giray Tekin Ebru Ece Saribaş Beran Yokuş Mehmet Çolak Eylem Özdemir Kaya Tuba Talo Yildirim Filiz Acun Kaya Ersin Uysal

https://doi.org/10.17567/currresdentsci.1754303

Abstract

Aim: The aim of this study was to investigate the possible relationships between periimplant sulcular fluid tumor necrosis factor alpha (TNF-α) levels and clinical parameters of periodontal disease and the amount of early alveolar bone loss in one-stage and two-stage implant systems.
Method: Standard Plus (SP) one-stage implants were placed in 20 of 40 patients who were missing mandibular 1st molars while Bone Level (BL) two-stage implants were placed in the rest of 20 patients. In order to determine the periodontal status of each individual, Modified Plaque Index (mPI), Modified Gingival Index (mGI), Modified Sulcular Bleeding Index (mSBI), Probing Pocket Depth (PPD) and peri-implanter sulcular fluids (PISF) were recorded before prosthesis loading (month 0), 3rd and 6th months after prosthesis loading. Radiological evaluation was performed with computed tomography (CT) images prior to loading and 6 months after prosthesis loading.
Results: In comparison, PPD values in the SP group are higher than in the BL group (P <.05). TNF-α, PPD values and rate of alveolar bone loss (ABL%) increased significantly between 0th and 6th month in terms of in-group evaluations in the SP group. In BL group, meaningful increases were observed in TNF-α and mSBI values between 0th and 6th months, in PISF volume between first 3 month period and first six month period.
Conclusion: Predictable results were observed to be obtained in two different systems as laboratory clinically and radiologically. TNF-α levels were significantly increased in both groups.
Keywords: Dental implant, tumor necrosis factor alpha, alveolar bone loss

Keywords

Dental implant , tumor necrosis factor alpha , alveolar bone loss

References

• 1. Misch C.E: Contemporary Implant Denstry: Rationale For Implants. 3nd edition, Canada, 2008, Mosby, 3.
• 2. Stanley M, Braga FC, Jordao BM. Immediate loading of single implants in the anterior maxilla: A 1-year prospective clinical study on 34 patients. Int J Dent. 2017;2017:1-11.
• 3. The Glossary of Prosthodontic Terms. J Prosthet Dent. 2005;94:10-92.
• 4. Chrcanovic BR, Albrektsson T, Wennerberg A. Immediately loaded non-submerged versus delayed loaded submerged dental implants: A meta-analysis. Int J Oral Maxillofac Surg. 2015;44:493–506.
• 5. Esposito M, Grusovin MG, Yun SC, Coulthard P, Worthington HV. One-stage versus two-stage implant placement. A Cochrane systematic review of randomised controlled clinical trials. Eur J Oral Implantol. 2009;2(2):91-99.
• 6. Chen M, Cai W, Zhao S, et al. Oxidative stress‐related biomarkers in saliva and gingival crevicular fluid associated with chronic periodontitis: A systematic review and meta‐analysis. J Clin Periodontol. 2019;46:608–622.
• 7. Mc Cauley LK, Nohutçu RM. Mediators of periodontal destruction and remodeling: principles and implications for diagnosis and therapy. J Periodontol. 2002;73:1377-1391.
• 8. Enver A, Özmeriç N. Evaluation the Relationship Between PeriodontalDisease and Inflammatory Bowel Diseases by Emphasizing the Role of Cytokines. J Clin Sci. 2021;10(2):143-149.
• 9. Zamri F, Vries TJ. Use of TNF inhibitors in rheumatoid arthritis and implications for the periodontal status: for the benefit of both? Front Immunol. 2020;11:1-11.
• 10. Vassali P. The pathophysiology of tumor necrosis factors. Ann Rev Immunol. 1992;10:411-452.
• 11. Graves D, Delima A, Assuma R. Interleukin-1 and tumor necrosis factor antagonists inhibit the progression of inflammatory cell infiltration toward alveolar bone in experimental periodontitis. J Periodontol. 1998;69:1419–1425.
• 12. Duarte PM, de Mendonça AC, Maximo MBB, Santos VR, Bastos MF, Nociti Junior FH. Differential cytokine expressions affect severity of peri-implant disease. Clin Oral Impl Res. 2009;20:514–520.
• 13. Dobresu M-L, Caraiane A, Raftu G, et al. Alpha tumor necrosis-as predictive factor in dental implant management. Romanian J Oral Rehabil. 2022;14(3):91-95.
• 14. Ghassib I, Chen Z, Zhu J, Wang H-L. Use of IL-1 β, IL-6, TNF-α, and MMP-8 biomarkers to distinguish peri-implant diseases: A systematic review and meta-analysis. Clin Implant Dent Relat Res. 2019;21(1):190–207.
• 15. Mombelli A, van Oosten MA, Schurch E Jr, et al. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol. 1987;2:145–151.
• 16. Loe H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol. 1967;38(6):610–616.
• 17. Ramfjord SP. The Periodontal Disease Index (PDI). J Periodontol. 1967;38:602–610.
• 18. Rudin HJ, Overdizk HF, Rateitschack KH. Correlation between sulkuler fluid rate and clinical and histological inflammation of the marginal gingiva. Helv Odont Acta. 1970;14(1):21-26.
• 19. Boynueğri D, Nemli SK, Yalım M. Dental implantlar çevresindeki kemik yıkımında mikro boşluğun önemi. Atatürk Üniv Diş Hek Fak Derg. 2011;4:9-14.
• 20. Nemli SK, Güngör MB, Aydın C, Yılmaz H, Türkcan İ, Demirköprülü H. Clinical evaluation of submerged and non-submerged implants for posterior single-tooth replacements: a randomized split-mouth clinical trial. International J Oral and Maxillofac Surg. 2014;43(12): 1484–1492.
• 21. Heijdenrijk K, Raghoebar GM, Meijer HJA, Stegenga B, Van der Reijden WA. Feasibility and influence of the microgap of two implants placed in a non-submerged procedure: A five-year follow-up clinical trial. J Periodontol. 2006;77(6):1051–1060.
• 22. Chehroudi B, Gould TR, Brunette DM. The role of connective tissue in inhibiting epithelial downgrowth on titanium-coated percutaneous implants. J Biomed Mater Res. 1992;26(4):493-515.
• 23. Lekholm U, Adell R, Lindhe J. Marginal tissue reactions at osseointegrated titanium fixtures. II. A cross-section retrospective study. Int J Oral Maxillofac Surg. 1986;15:53-61.
• 24. Hultin M, Gustafsson A, Klinge B. Long-term evaluation of osseointegrated dental implants in the treatment of partly edentulous patients. J Clin Periodontol. 2000;27:128–133.
• 25. Hammerle CH, Glauser R. Clinical evaluation of dental implant treatment. Periodontology 2000. 2004;34:230-239.
• 26. Hobo S, Ichida E, Garcia LT. Osseointegration and occlusal rehabilitation. 2nd ed. Tokyo: Quintessence Publishing CO; 1990.
• 27. Hermann JS, Buser D, Schenk RK, Cochran DL. Crestal bone changes around titanium implants. A histometric evaluation of unloaded non- 103 submerged and submerged implants in the canine mandible. J Periodontol. 2000;71(9):1412-1424.
• 28. Gheisari R, Eatemadi H, Alavian A. Comparison of the Marginal Bone Loss in One-stage versus Two-stage Implant Surgery. J Dent Shiraz Univ Med Sci. 2017;18(4):272-276.
• 29. Astrand P, Enqquist B, Anzaon B, et al. Non-submerged implants in the treatment of the edentulous lower jaw. A 2-year longitudinal study. Clin Implant Dent Relat Res. 2002;4(3):115-127.
• 30. Siadat H, Panjnoosh M, Alikhasi M, Alihoseini M, Bassir SH, Rokn AR. Does implant staging choice affect crestal bone loss? J Oral Maxil Surg. 2012;70(2):307-313.
• 31. Menini M, Pesce P, Delucchi F, et al. One-stage versus two-stage technique using two splintedextra-short implants: A multicentric split-mouth study with aone-year follow-up. Clin Implant Dent Relat Res. 2022;24(5):602‐610.
• 32. Venza M, Visalli M, Lo Giudice G, Cicciù M, Passi P, Teti D. Changes in inflammatory mediators in peri-implant fluid after implant insertion. J Periodontol. 2009;80(2):297-306.
• 33. Kim YK, Kim SG, Oh HK, et al. Evaluation of peri-implant tissue in nonsubmerged dental implants: a multicenter retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:189-195.
• 34. Heckmann SM, Linke JJ, Graef F, Foitzik Ch, Wichmann MG, Weber H-P. Stress and inflammation as a detrimental combination for peri-implant bone loss. J Dent Res. 2006;85:711-716.
• 35. Ghassib I, Chen Z, Zhu J, Wang H-L. Use of IL-1 β, IL-6, TNF-α, and MMP-8 biomarkers to distinguish peri-implant diseases: A systematic review and meta-analysis. Clin Implant Dent Related Res. 2019;21(1):190-207.
• 36. Gamonal J, Sanz M, O’Connor A, et al. Delayed neutrophil apoptosis in chronic periodontitis patients. J Clin Periodontol. 2003;30:616–623.
• 37. Kurtiş B, Tüter G, Serdar M, et al. Gingival crevicular fluid levels of monocyte chemoattractant protein-1 and tumor necrosis factor-alpha in patients with chronic and aggressive periodontitis. J Periodontol. 2005;76(11):1849-1855.
• 38. Machtei EE, Oved-Peleg E, Peled M. Comparison of clinical, radiographic and immunological parameters of teeth and different dental implant platforms. Clin Oral Impl Res. 2006;17:658–665.