Role of Reactive Oxygen Species and Advanced Glycation End Products in the Malfunctioning of Dental Implants

Abstract

Objective: In the last decade, dental implants have emerged as a crucial modality and serve as an individual form of therapy for dental failure. However, disparities in host responses have led to peri-implantitis and implant failure. The pathological mechanisms driving peri-implantitis remain largely unknown. In this study, we evaluated the role of oxidative stress and advanced glycation end products (AGE) in the progression of peri-implantitis and dental implants failure, compared with chronic periodontal disease.

Subjects and methods: Three patient groups (peri-implantitis, chronic periodontal disease and control), each with 10 subjects (7M/3F) and average age ranging from 40-60 years were selected for analysis. Salivary oxidative stress and tissue AGE levels were analysed by probing for reactive oxygen species (ROS) and Maillard reaction-related fluorescence, respectively.

Results: We observed significant increase (> 2-fold) in oxidative stress and AGE levels in patients with peri-implantitis and chronic periodontal disease compared to controls, with chronic periodontal disease having the highest levels. In addition, we observed a strong positive correlation (r = 0.94) between oxidative stress and AGE levels in the patients.

Conclusion: We propose that increased AGE levels and oxidative stress, although not the only pathway, are significant mediators in the pathogenesis of peri-implantitis. Altering them may potentially be used in combination with other modalities to manage peri-implantitis.

Figures

Fig. 1. Oxidative stress analysis. Oxidative stress was analysed by probing for reactive oxygen species. Reactive oxygen species was measured in saliva samples through thiobarbituric acid reactive substances assay for the three groups – peri-implantitis, periodontal disease and control. Values are provided as mean ± standard deviation (n = 10 each). Statistical significance was observed between all groups (*p < 0.0001).

Fig. 2. Advanced glycation end products analysis. Advanced glycation end products levels were measured in tissue samples through Maillard reaction-related fluorescence for all three groups – peri-implantitis, periodontal disease and control. Values are provided as mean ± standard deviation (n = 10 each). Statistical significance was seen between all groups (*p < 0.0001).

Fig. 3. Correlation analysis. Thiobarbituric acid reactive substances (TBARS) assay units of patients were plotted against corresponding advanced glycation end products (AGE) assay units to evaluate the correlation between them. Two-tailed Pearson correlation analysis was performed (r = 0.94; p