Peri-implantitis Clinical Trial
Official title:
Evaluation of Pro-inflammatory Mediators Around Astra Tech Dental Implant Abutments Following a Minimum of 6 Months of Clinical Function
The purpose of this study is to determine whether there are differences in inflammatory markers and bone-mediator protein expression in the fluid surrounding implant abutments manufactured with either titanium or zirconium.
The aim of this cross-sectional study is to utilize the paper strip-based peri-implant
crevicular fluid (PICF) sampling technique to evaluate the influence that transmucosal
abutment biomaterials of either titanium or zirconium oxide, which have been in situ for
greater than six months, have in the expression of specific pro-inflammatory and
bone-mediators.
Subjects who had previously undergone single-tooth implant replacement therapy are invited to
participate and informed consent is obtained.
All participants receive a clinical and radiographic exam of the implant site that is sampled
for PICF. Clinical and radiographic parameters such as implant mobility, presence or absence
of supragingival plaque, and interproximal bone levels were assessed. Peri-apical
radiographs, utilizing a paralleling technique, will be obtained from each implant fixture to
evaluate the marginal bone level compared to baseline periapical radiographs made at the time
of definitive prosthesis delivery. Each participant's implant site is isolated with cotton
rolls, light air is applied over the site to eliminate the potential for ambient salivary
contamination of the PICF sample. The implant site is sampled for 30 seconds at four distinct
sites (mesio-buccal, disto-buccal, mesio-lingual, disto-lingual) by one clinician under loupe
magnification. The fluid volumes collected on each strip will be quantified using the
Periotron 8000 Instrument.
Cytokine, chemokine, and bone mediator quantities (pg/30 s) were determined using a
commercial 22-multiplexed fluorescent bead-based immunoassay. Two specific multiplex kits are
utilized (Milliplex MAP Human cytokine/Chemokine Immunoassay & Milliplex MAP Human Bone Panel
1B Immunoassay).
Biostatisticians are masked to the implant abutment biomaterial designations (masked as "A"
and "B") during data analysis. Initial bivariate analysis using the Wilcoxon-Mann-Whitney
(Wilcoxon Rank Sum) test will be employed to assess the difference in distribution between
the two groups (titanium dioxide or zirconium oxide) for each cytokine/bone mediator and for
age. The same approach is used to consider whether a gender difference was associated with a
particular cytokine/bone mediator. Gender distribution in the two groups will be compared
using the Fisher exact test. The Spearman rank correlation will be used to assess the
possibility of a relationship with age for each cytokine. Rank-based regression models will
be used to adjust for possible effects of age and gender for both cytokine and bone mediator
levels.
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