Simferopol, Simferopol, Russian Federation
employee
Simferopol, Simferopol, Russian Federation
Simferopol, Simferopol, Russian Federation
Simferopol, Simferopol, Russian Federation
UDK 616 Патология. Клиническая медицина
An inflammatory process in the gingival and/or periodontal tissues prior to implantation seems to be a significant risk factor contributing to impaired osteointegration with implant rejection in the early or late stages due to the development of periimplantation mucositis followed by periimplantitis. In this regard, the task of searching for highly informative markers, both morphological and laboratory, as well as molecular genetic markers, remains extremely relevant, allowing predicting the risk of developing periimplantitis in various populations. An equally urgent task is the search for effective means of adjuvant therapy and prevention of inflammatory complications after dental implantation. The aim of this study was a comprehensive histopathological assessment of the state of the gingiva by biopsy at the stage before implantation in a clinical case series. In a clinical case series (25 patients), using a descriptive histological method, a histopathological analysis of gingival biopsy samples obtained at the stage of implant placement was performed. The data of the descriptive histological analysis were supplemented by the results of an immunohistochemical study for the expression of vitamin D receptors (VDR) in the gingival tissues and inflammatory infiltration cells. According to the results of a descriptive histopathological analysis, in 7 out of 25 cases (28%) in the gingival tissues of the edentulous area of the jaw in the area of the included defect of the dentition, the phenomenon of less or more pronounced chronic inflammation was revealed, manifested in lymphocytic or mixed lymphohistiocytic infiltration. Other significant histopathological changes were presented by the changes in the gingival epithelium, as well as disorders in the vessels of the microvasculature. Immunohistochemical analysis demonstrated the presence of a strong nuclear and/or cytoplasmic expression of VDR both in the epithelium and cells of the inflammatory infiltrate, regardless of the age and gender of the patients or the severity of inflammatory changes in the gingival tissues. The results of the pilot analysis of clinical case series are of interest for further study of pre-implantation gingival or periodontal lesions, and may help identify biomarkers of the subsequent development of periimplantitis, as well also provide a fundamental rationale for the use of vitamin D as a prophylactic or therapeutic adjuvant.
gingiva, morphology, inflammation, vitamin D receptor, dental implantation
1. Corvino E., Pesce P., Camodeca F., Moses O., Iannello G., Canullo L. Clinical and radiological outcomes of implants with two different connection configurations: A randomised controlled trial // Int J Oral Implantol (Berl). - 2020;13(4):355-368. PMID: 33491367.
2. Garcia-Sanchez R., Dopico J., Kalemaj Z., Buti J., Pardo Zamora G., Mardas N. Comparison of clinical outcomes of immediate versus delayed placement of dental implants: A systematic review and meta-analysis // Clin Oral Implants Res. - 2022;33(3):231-277. https://doi.org/10.1111/clr.13892.
3. Kochar S.P., Reche A., Paul P. The Etiology and Management of Dental Implant Failure: A Review // Cureus. - 2022;19;14(10):e30455. https://doi.org/10.7759/cureus.30455.
4. Do T.A., Le H.S., Shen Y.W., Huang H.L., Fuh L.J. Risk Factors related to Late Failure of Dental Implant-A Systematic Review of Recent Studies // Int J Environ Res Public Health. - 2020;2;17(11):3931. https://doi.org/10.3390/ijerph17113931.
5. Rokaya D., Srimaneepong V., Wisitrasameewon W., Humagain M., Thunyakitpisal P. Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment // Eur J Dent. - 2020;14(4):672-682. https://doi.org/10.1055/s-0040-1715779.
6. Anitua E., Montalvillo A., Eguia A., Alkhraisat M.H. Clinical outcomes of dental implants placed in the same region where previous implants failed due to peri-implantitis: a retrospective study // Int J Implant Dent. - 2021;9;7(1):109. https://doi.org/10.1186/s40729-021-00392-1.
7. Maruyama N., Maruyama F., Takeuchi Y., Aikawa C., Izumi Y., Nakagawa I. Intraindividual variation in core microbiota in peri-implantitis and periodontitis // Sci Rep. - 2014;4:6602. https://doi.org/10.1038/srep06602.
8. Rajasekar A., Varghese S.S. Microbiological Profile in Periodontitis and Peri-Implantitis: A Systematic Review // J Long Term Eff Med Implants. - 2022;32(4):83-94. https://doi.org/10.1615/JLongTermEffMedImplants.2022043121.
9. Leonhardt A., Renvert S., Dahlén G. Microbial findings at failing implants // Clin Oral Implants Res. - 1999;10(5):339-345. https://doi.org/10.1034/j.1600-0501.1999.100501.x.
10. Alsulaimani L., Alqarni A., Almarghlani A., Hassoubah M. The Relationship Between Low Serum Vitamin D Level and Early Dental Implant Failure: A Systematic Review // Cureus. - 2022;15;14(1):e21264. https://doi.org/10.7759/cureus.21264.
11. Werny J.G., Sagheb K., Diaz L., Kämmerer P.W., Al-Nawas B., Schiegnitz E. Does vitamin D have an effect on osseointegration of dental implants? A systematic review // Int J Implant Dent. - 2022;11;8(1):16. https://doi.org/10.1186/s40729-022-00414-6.
12. Fletcher J., Cooper S.C., Ghosh S., Hewison M. The role of vitamin D in inflammatory bowel disease: mechanism to management // Nutrients. - 2019;11(5):1019. https://doi.org/10.3390/nu11051019.
13. Kulakov A.A., Kogan E.A., Nikolenko V.N., Braylovskaya T.V., Vedyaeva A.P., Blinova E.V., Zharkov N.V., Boev S.P. Kliniko-morfologicheskoe i immunogistohimicheskoe issledovanie tkaney pri periimplantite i parodontite. Medicinskiy vestnik Severnogo Kavkaza. 2019;14(4):653-659. [A.A. Kulakov, E.A. Kogan, V.N. Nikolenko, T.V. Brailovskaya, A.P. Vedyaeva, E.V. Blinova, N.V. Zharkov, S.P. Boev. Clinical-morphological and immunohistochemical study of tissues in peri-implantitis and periodontitis. Medical News of North Caucasus. 2019;14(4):653-659. (In Russ.)]. https://doi.org/10.14300/mnnc.2019.14162.
14. Leuci S., Coppola N., Adamo N., Bizzoca M.E., Russo D., Spagnuolo G., Lo Muzio L., Mignogna M.D. Clinico-Pathological Profile and Outcomes of 45 Cases of Plasma Cell Gingivitis // J Clin Med. - 2021;18;10(4):830. https://doi.org/10.3390/jcm10040830.
15. Popa G.V., Costache A., Badea O., Cojocaru M.O., Mitroi G., Lazăr A.C., Olimid D.A., Mogoantă L. Histopathological and immunohistochemical study of periodontal changes in chronic smokers // Rom J Morphol Embryol. - 2021;62(1):209-217. https://doi.org/10.47162/RJME.62.1.20.
16. Karoussis I.K., Salvi G.E., Heitz-Mayfield L.J., Brägger U., Hämmerle C.H., Lang N.P. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI Dental Implant System // Clin Oral Implants Res. - 2003;14(3):329-339. https://doi.org/10.1034/j.1600-0501.000.00934.x.
17. Hardt C.R., Gröndahl K., Lekholm U., Wennström J.L. Outcome of implant therapy in relation to experienced loss of periodontal bone support: a retrospective 5- year study // Clin Oral Implants Res. - 2002;13(5):488-494. https://doi.org/10.1034/j.1600-0501.2002.130507.x.
18. Oh C., Kim H.J., Kim H.M. Vitamin D maintains E-cadherin intercellular junctions by downregulating MMP-9 production in human gingival keratinocytes treated by TNF-α // J Periodontal Implant Sci. - 2019;21;49(5):270-286. https://doi.org/10.5051/jpis.2019.49.5.270.
19. Taskan M.M., Gevrek F. PPAR-γ, RXR, VDR, and COX-2 Expressions in gingival tissue samples of healthy individuals, periodontitis and peri-implantitis patients // Niger J Clin Pract. - 2020;23(1):46-53. https://doi.org/10.4103/njcp.njcp_349_19.
20. Trochoutsou A.I., Kloukina V., Samitas K., Xanthou G. Vitamin-D in the Immune System: Genomic and Non-Genomic Actions // Mini Rev Med Chem. - 2015;15(11):953-963. https://doi.org/10.2174/1389557515666150519110830.
21. Hii C.S., Ferrante A. The Non-Genomic Actions of Vitamin D // Nutrients. - 2016;2;8(3):135. https://doi.org/10.3390/nu8030135.
22. Lu M., Taylor B.V., Körner H. Genomic Effects of the Vitamin D Receptor: Potentially the Link between Vitamin D, Immune Cells, and Multiple Sclerosis // Front Immunol. - 2018;12;9:477. https://doi.org/10.3389/fimmu.2018.00477.
23. Minton K. Vitamin D shuts down T cell-mediated inflammation // Nat Rev Immunol. - 2022;22(1):1. https://doi.org/10.1038/s41577-021-00663-3.
24. Hafkamp F.M.J., Taanman-Kueter E.W.M., van Capel T.M.M, Kormelink T.G., de Jong E.C. Vitamin D3 Priming of Dendritic Cells Shifts Human Neutrophil-Dependent Th17 Cell Development to Regulatory T Cells // Front Immunol. - 2022;13:872665. https://doi.org/10.3389/fimmu.2022.872665.
25. Rodríguez-Archilla A., Mohamed-El-Founti N. Association of periodontitis with vitamin D and calcium levels: a meta-analysis // Iberoam J Med. - 2023;5(1):36-45. https://doi.org/10.53986/ibjm.2023.0003.
26. Machado V., Lobo S., Proença L., Mendes J.J., Botelho J. Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis // Nutrients. - 2020;12(8):2177. https://doi.org/10.3390/nu12082177.
