Efeito do tratamento na expressão de citocinas relacionadas à resposta Th17 no fluido peri-implantar de pacientes com mucosite e peri-implantite: um estudo longitudinal prospectivo

Abstract

This study aimed to evaluate the effect of peri-implant treatment on the expression of cytokines related to the Th17 response in the peri-implant crevicular fluid (PICF) (GM-CSF, IFN-γ, IL-1β, IL-4, IL-6, IL-10, IL-12(p70), IL-17A, IL-21, IL-23, and TNF-α) of partially edentulous patients with osseointegrated implants and peri-implant disease (PID). Thirty-seven systemically healthy individuals of both genders were divided into two groups: peri-implant mucositis (MU) (n = 20) and peri-implantitis (PI) (n = 17). The clinical parameters evaluated were probing depth (PD), clinical attachment level (CAL), plaque index and bleeding index. The MU group was treated by a non-surgical approach and the PI group by a surgical approach. PICF collection was conducted using absorbent paper strips and immunological analysis was performed using a multiplex assay. Patients' perceptions of disease and its impact on quality of life were assessed using questionnaires (Symptom Perception Questionnaire and OHIP-14). Patients were evaluated at baseline (T0) and at three months after treatment (T1). A total of 88 implants were assessed and treated, with 56 in the MU group (63.63%) and 32 in the PI group (36.37%) (p = 0.011). The results after treatment of full-mouth clinical data demonstrated that in the MU group, there was no statistically significant difference in any clinical parameter evaluated. However, the PI group exhibited significant reductions in PD (p = 0.006) and bleeding index (p = 0.008). At the implant level, the MU group showed significant reductions in PD, CAL, plaque index, and bleeding index (p = 0.001; p = 0.000; p = 0.003 and p = 0.000, respectively) and the PI group showed significant reductions in PD, CAL, and bleeding index (p = 0.000; p = 0.004 and p = 0.000, respectively). Comparison of immunological data between MU and PI groups at T0 revealed no significant difference (p > 0.05). After treatment, significant reductions in the expression of IL-17A (p = 0.010) and TNF-α (p = 0.035) were observed in the MU group. In the PI group, there were significant reductions in the expression of IL-1β (p = 0.049), IL-6 (p = 0.010), and TNF-α (p = 0.011). No significant differences were found in OHIP-14 scores at T0, or post-treatment (p > 0.05). These findings suggest that peri-implant treatment can effectively regulate important cytokines in the exacerbation of the inflammatory response and osteoclastogenesis.