Investigation of Macrophage Polarization in Peri-implant Health and Peri-implantitis
Peri-implantitis is a chronic inflammatory disease characterized by plaque-associated inflammation of the peri-implant mucosa and progressive loss of supporting bone around dental implants, which may ultimately lead to implant failure if left untreated.
It has been demonstrated that cellular and molecular responses of the host immune defense system play a critical role in the pathogenesis of peri-implantitis. Macrophages are key cells in the host immune response and are generally classified into two phenotypes: pro-inflammatory (M1) and anti-inflammatory (M2). While M1 macrophages are actively involved in the early defense response, a shift toward the M2 phenotype is required for the resolution of inflammation and tissue repair.
Smoking has been shown to adversely affect macrophage polarization and function, thereby exacerbating inflammatory responses. Therefore, in the present study, levels of soluable CD163 (sCD163), B cell activating factor (BAFF), tumor necrosis factor-like weak inducer of apoptosis (TWEAK), a proliferation-inducing ligand (APRIL), interferon-gamma (IFN-γ), interleukin-10 (IL-10), interleukin-34 (IL-34), interleukin-35 (IL-35), and arginase activity (ornithine levels) will be evaluated in peri-implant health and peri-implantitis patients with varying disease severity and different smoking statuses. In addition, a comprehensive proteomic analysis will be performed to investigate the relationships among peri-implantitis severity, smoking, and macrophage polarization-related molecules. Baseline periodontal and peri-implant parameters will be recorded for all participants. In the peri-implant health group, tissue samples will be collected during exposure surgery performed for submerged implants, after which participants will be enrolled in supportive peri-implant care. Participants diagnosed with peri-implantitis will receive non-surgical therapy, during which tissue samples will be collected. Periodontal and peri-implant parameters will be reassessed for all participants at baseline, and at 6 and 12 weeks. Healthy peri-implant samples will be collected from submerged implants during exposure surgery. Peri-implantitis samples (probable pocket depth ≥ 6 mm with bleeding on probing) will be obtained during non-surgical therapy using a single stroke along the pocket wall.
Descripción general del estudio
Estado
Condiciones
Tipo de estudio
Inscripción (Estimado)
Contactos y Ubicaciones
Ubicaciones de estudio
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Istanbul, Turquía (Türkiye)
- Reclutamiento
- Biruni University
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Contacto:
- Burcu Karaduman
- Número de teléfono: +905323763366
- Correo electrónico: bkaraduman@biruni.edu.tr
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Sub-Investigador:
- Ayse Kaban
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Método de muestreo
Población de estudio
Descripción
Inclusion Criteria:
- Individuals who is suitable for the peri-implantitis diagnosis according to the classifications of periodontal and peri-implant diseases and conditions established in 2017.
- Individuals with at least one bone-level dental implant and scheduled to undergo exposure surgery.
Exclusion Criteria:
- prior peri-implantitis surgery
- being diagnosed with autoimmune disease, genetic disorders, bone metabolism disorders, poorly controlled systemic diseases (such as diabetes or hypertension)
- pregnancy or lactation
- having a history of oral malignancy, chemotherapy or radiotherapy
- use of anti-inflammatory drugs within 2 weeks, antibiotics within 3 months,
- need for prophylactic antibiotics
- contraindications for dental/surgical procedures.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
Cohortes e Intervenciones
Grupo / Cohorte |
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Peri-implant health - smokers
Individuals with at least one bone-level dental implant, who are current smokers, and are scheduled to undergo exposure surgery.
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Peri-implant health - non-smokers
Individuals with at least one bone-level dental implant, who are non-smokers, and are scheduled to undergo exposure surgery.
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Peri-implantitis - non-smokers
Individuals with peri-implantitis (non-smokers) were defined as subjects who were non-smokers and presented with bleeding and/or suppuration on gentle probing, an increased probing depth compared to previous examinations, and radiographic evidence of bone loss beyond crestal bone level changes resulting from initial bone remodelling.
In cases where previous examination data were not available, peri-implantitis was diagnosed based on the presence of bleeding and/or suppuration on gentle probing, probing depths of ≥6 mm, and radiographic bone levels ≥3 mm apical to the most coronal portion of the intraosseous part of the implant.
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Peri-implantitis - smokers
Individuals with peri-implantitis (smokers) were defined as subjects who were current smokers and presented with bleeding and/or suppuration on gentle probing, an increased probing depth compared to previous examinations, and radiographic evidence of bone loss beyond crestal bone level changes resulting from initial bone remodelling.
In cases where previous examination data were not available, peri-implantitis was diagnosed based on the presence of bleeding and/or suppuration on gentle probing, probing depths of ≥6 mm, and radiographic bone levels ≥3 mm apical to the most coronal portion of the intraosseous part of the implant.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Evaluation of soluable CD163 (sCD163) levels
Periodo de tiempo: Baseline
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sCD163 levels in tissue samples collected from the participants will be evaluated using Bio-Plex multiplex kits.
The results of the biochemical analyses will be reported as pg/ng.
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Baseline
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Evaluation of a proliferation-inducing ligand (APRIL) levels
Periodo de tiempo: Baseline
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APRIL levels in tissue samples collected from the participants will be evaluated using Bio-Plex multiplex kits.
The results of the biochemical analyses will be reported as pg/ng.
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Baseline
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Evaluation of B-cell activating factor (BAFF) levels
Periodo de tiempo: Baseline
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BAFF levels in tissue samples collected from the participants will be evaluated using Bio-Plex multiplex kits.
The results of the biochemical analyses will be reported as pg/ng.
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Baseline
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Evaluation of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) levels
Periodo de tiempo: Baseline
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TWEAK levels in tissue samples collected from the participants will be evaluated using Bio-Plex multiplex kits.
The results of the biochemical analyses will be reported as pg/ng.
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Baseline
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Evaluotion of interleukin-10 (IL-10) levels
Periodo de tiempo: Baseline
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IL-10 levels in tissue samples collected from the participants will be evaluated using Bio-Plex multiplex kits.
The results of the biochemical analyses will be reported as pg/ng.
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Baseline
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Evaluation of interleukin-34 (IL-34) Levels
Periodo de tiempo: Baseline
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IL-34 levels in tissue samples collected from the participants will be evaluated using Bio-Plex multiplex kits.
The results of the biochemical analyses will be reported as pg/ng.
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Baseline
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Evaluation of interleukin-35 (IL-35) levels
Periodo de tiempo: Baseline
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IL-35 levels in tissue samples collected from the participants will be evaluated using Bio-Plex multiplex kits.
The results of the biochemical analyses will be reported as pg/ng.
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Baseline
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Evaluation of arginase activity
Periodo de tiempo: Baseline
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Arginase activity in tissue samples collected from the participants will be evaluated using Chinard's method by determined ornithine levels.
The results of the biochemical analyses will be reported as pg/ng.
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Baseline
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Probable pocket depth (PPD)
Periodo de tiempo: Baseline and 6th week.
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Probable pocket depth wiil be measured using a periodontal probe
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Baseline and 6th week.
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Bleeding on probing (BoP)
Periodo de tiempo: Baseline and 6th week.
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The presence of visible bleeding following periodontal probing will be assessed by visual inspection (+/-).
The total bleeding score will be expressed as a percentage.
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Baseline and 6th week.
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Plaque index
Periodo de tiempo: Baseline and 6th week.
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The presence of visible plaque will be evaluated with a periodontal probe (+/-).
The total plaque score will be expressed as a percentage.
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Baseline and 6th week.
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Silla de estudio: Burcu Karaduman, PhD, Biruni University
- Silla de estudio: Ulvi K Gursoy, PhD, University of Turku
- Silla de estudio: Mustafa Yilmaz, PhD, Istanbul University
- Investigador principal: Ayse Kaban, Biruni University
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 2024-BIAEK/16-60
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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