Hyaluronic acid reduces inflammation and crevicular fluid IL-1β concentrations in peri-implantitis: a randomized controlled clinical trial
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)- 1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, −1.66, −0.40 mm; control 2: 95% CI, −1.07, −0.01 mm) and 90 days (control 1: 95% CI, −1.72, −0.54 mm; control 2: 95% CI, −1.13, −0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels. Trial Registration: ClinicalTrials.gov Identifier: NCT03157193
Abstract
Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)- 1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, −1.66, −0.40 mm; control 2: 95% CI, −1.07, −0.01 mm) and 90 days (control 1: 95% CI, −1.72, −0.54 mm; control 2: 95% CI, −1.13, −0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels. Trial Registration: ClinicalTrials.gov Identifier: NCT03157193
참고문헌 (38)
- Dahiya P, "Hyaluronic acid : a boon in periodontal therapy", N Am J Med Sci, 5, pp.309~315 (2013)
- Sutherland IW, "Novel and established applications of microbial polysaccharides", Trends Biotechnol, 16, pp.41~46 (1998)
- Moreland LW, "Intra-articular hyaluronan(hyaluronic acid)and hylans for the treatment of osteoarthritis : mechanisms of action", Arthritis Res Ther, 5, pp.54~67 (2003)
- Chen WY, "Functions of hyaluronan in wound repair", Wound Repair Regen, 7, pp.79~89 (1999)
- Berglundh T, "Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions", J Clin Periodontol, 45(Suppl 20), pp.S286~291 (2018)
- Smith AJ, "Gingival crevicular fluid glycosaminoglycan levels in patients with chronic adult periodontitis", J Clin Periodontol, 22, pp.355~361 (1995)
- Manzanares D, "Apical oxidative hyaluronan degradation stimulates airway ciliary beating via RHAMM and RON", Am J Respir Cell Mol Biol, 37, pp.160~168 (2007)
- Duarte PM, "Could cytokine levels in the peri-implant crevicular fluid be used to distinguish between healthy implants and implants with periimplantitis? A systematic review", J Periodontal Res, 51, pp.689~698 (2016)
- Casale M, "Hyaluronic acid: Perspectives in dentistry. A systematic review", Int J Immunopathol Pharmacol, 29, pp.572~582 (2016)
- Soriano-Lerma A, "Short-term effects of hyaluronic acid on the subgingival microbiome in peri-implantitis : a randomized controlled clinical trial", J Periodontol, 91, pp.734~745 (2020)
- Lopez MA, "The use of hyaluronic acid as an adjuvant in the management of peri-implantitis", J Biol Regul Homeost Agents, 31, pp.123~127 (2017)
- Schulz KF, "CONSORT 2010 statement : updated guidelines for reporting parallel group randomised trials", J Clin Epidemiol, 63, pp.834~840 (2010)
- Coli P, "Reliability of periodontal diagnostic tools for monitoring periimplant health and disease", Periodontol 2000, 73, pp.203~217 (2017)
- Statistical power analysis for the behavioural sciences, "Cohen J", Lawrence Erlbaum Associates, ~ (1988)
- Ainamo J, "Problems and proposals for recording gingivitis and plaque", Int Dent J, 25, pp.229~235 (1975)
- Zweers J, "Clinical and radiographic evaluation of narrow- vs. regular-diameter dental implants: a 3-year follow-up. A retrospective study", Clin Oral Implants Res, 26, pp.149~156 (2015)
- Mombelli A, "Black-pigmenting gram-negative bacteria in periodontal disease. I. Topographic distribution in the human dentition", J Periodontal Res, 26, pp.301~307 (1991)
- Crespi R, "Nonsurgical treatment of peri-implantitis without eliminating granulation tissue : a 3-year study", Implant Dent, 28, pp.4~10 (2019)
- Astasov-Frauenhoffer M, "Microcalorimetric determination of the effects of amoxicillin, metronidazole, and their combination on in vitro biofilm", J Periodontol, 85, pp.349~357 (2014)
- Klockars AJ, "Multiple comparisons" (1986), Sage Publications Inc
- Altman DG, "Practical statistics for medical research" (1991), Chapman & Hall
- Renvert S, "Treatment of peri-implantitis using an Er : YAG laser or an air-abrasive device : a randomized clinical trial", J Clin Periodontol, 38, pp.65~73 (2011)
- de Araújo Nobre M, "Peri-implant maintenance of immediate function implants : a pilot study comparing hyaluronic acid and chlorhexidine", Int J Dent Hyg, 5, pp.87~94 (2007)
- Goto M, "Intra-articular injection of hyaluronate(SI-6601D)improves joint pain and synovial fluid prostaglandin E2 levels in rheumatoid arthritis : a multicenter clinical trial", Clin Exp Rheumatol, 19, pp.377~383 (2001)
- Takahashi K, "The effects of hyaluronan on matrix metalloproteinase-3 (MMP-3), interleukin-1β (IL-1β), and tissue inhibitor of metalloproteinase-1 (TIMP-1)gene expression during the development of osteoarthritis", Osteoarthritis Cartilage, 7, pp.182~190 (1999)
- Sasaki A, "Hyaluronate inhibits the interleukin-1β-induced expression of matrix metalloproteinase(MMP)-1 and MMP-3 in human synovial cells", Tohoku J Exp Med, 204, pp.99~107 (2004)
- Nonaka T, "Hyaluronic acid inhibits the expression of u-PA, PAI-1, and u-PAR in human synovial fibroblasts of osteoarthritis and rheumatoid arthritis", J Rheumatol, 27, pp.997~1004 (2000)
- Wang CT, "High molecular weight hyaluronic acid down-regulates the gene expression of osteoarthritis-associated cytokines and enzymes in fibroblast-like synoviocytes from patients with early osteoarthritis", Osteoarthritis Cartilage, 14, pp.1237~1247 (2006)
- Bourguignon LY, "Interaction of low molecular weight hyaluronan with CD44and toll-like receptors promotes the actin filament-associated protein 110-actin binding and MyD88-NFκB signaling leading to proinflammatory cytokine", chemokine production and breast tumor invasion, 2011, pp.68, 671~693
- Johnson P, "A role for the cell adhesion molecule CD44 and sulfation in leukocyteendothelial cell adhesion during an inflammatory response?", Biochem Pharmacol, 59, pp.455~465 (2000)
- Siegelman MH, "The CD44-initiated pathway of T-cell extravasation uses VLA-4 but not LFA-1 for firm adhesion", J Clin Invest, 105, pp.683~691 (2000)
- Mesa FL, "Antiproliferative effect of topic hyaluronic acid gel. Study in gingival biopsies of patients with periodontal disease", Histol Histopathol, 17, pp.747~753 (2002)
- Eliezer M, "Hyaluronic acid as adjunctive to non-surgical and surgical periodontal therapy : a systematic review and meta-analysis", Clin Oral Investig, 23, pp.3423~3435 (2019)
- Alcântara CE, "Hyaluronic acid accelerates bone repair in human dental sockets : a randomized triple-blind clinical trial", Braz Oral Res, 32, pp.e84~ (2018)
- Faot F, "Can peri-implant crevicular fluid assist in the diagnosis of peri-implantitis? A systematic review and meta-analysis", J Periodontol, 86, pp.631~645 (2015)
- Sanz M, "Clinical research on peri-implant diseases: consensus report of Working Group 4", J Clin Periodontol, 39(Suppl 12), pp.202~206 (2012)
- Derks J, "Peri-implant health and disease. A systematic review of current epidemiology", J Clin Periodontol, 42(Suppl 16), pp.S158~171 (2015)
- Ata-Ali J, "Impact of heavy smoking on the clinical, microbiological and immunological parameters of patients with dental implants:a prospective cross-sectional study", J Investig Clin Dent, 7, pp.401~409 (2016)