AimTo investigate the association, as well as to characterize the associated panel of pro‐ and anti‐inflammatory markers, between the different components of the peri‐implant phenotype and the presence of peri‐implantitis/peri‐implant soft‐tissue dehiscence (PISTD).Materials and MethodsA total of 324 implants in 112 patients were included. The following components of the peri‐implant phenotype were clinically measured through the use of a manual periodontal probe or a digital calliper: keratinized mucosa width (PIKM‐W), mucosal thickness (MT), attached mucosa (AM) and vestibulum depth (VD). The presence of peri‐implantitis and PISTD was assessed through clinical and radiographic examination. Mixed‐models logistic regression analyses were performed to analyse the association between peri‐implant phenotype and the presence of peri‐implantitis or PISTD, adjusting for relevant confounders. Multiplex immunoassays were employed to evaluate the peri‐implant crevicular fluid levels of a panel of pro‐ and anti‐inflammatory markers.ResultsPeri‐implant health, peri‐implant mucositis and peri‐implantitis were diagnosed in 36.6%, 21.4% and 42% of the patients (classified according to their worst implant) and 35.2%, 34.3%, and 30.5% of the implants, respectively. In the multi‐level multiple regression model, the absence of PIKM‐W (odds ratio [OR] = 9.24; 95% CI: 2.73–31.28), the absence of attached mucosa (OR = 19.58; 95% CI: 6.12–62.56) and a reduced (<4 mm) vestibulum depth (OR = 2.61; 95% CI: 1.05–6.48) were associated with peri‐implantitis. Similarly, the absence of PIKM‐W (OR = 6.32; 95% CI: 1.67–23.83), a thin (<2 mm) mucosa (OR = 157.75; 95% CI: 14.06–1769.9) and a reduced vestibulum depth (OR = 3.32; 95% CI: 1.02–10.84) were associated with the presence of PISTD. Implants with PIKM‐W = 0 mm showed statistically significantly higher levels of interferon‐γ in both regular (≥2 maintenance/year) and irregular (<2 maintenance/year) compliers (p = 0.046 and p = 0.012). In irregular compliers, the absence of PIKM‐W was also associated with statistically significantly higher levels of interleukin (IL)‐1β and IL‐21 (p = 0.016, p = 0.046). These associations were independent of the effect of relevant confounders (e.g., plaque, compliance with maintenance, etc.).ConclusionsWithin their limits, the present findings indicate that (a) peri‐implant soft‐tissue phenotype appears to be associated with the presence of peri‐implantitis and PISTD, and (b) in the absence of PIKM‐W, the inflammatory response seems to be dysregulated and the soft‐tissue remodelling up‐regulated.

中文翻译：

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软组织表型作为种植体周围炎和种植体周围软组织裂开的风险指标——一项横断面研究


目的研究种植体周围表型的不同成分与种植体周围炎/种植体周围软组织裂开 （PISTD） 的存在之间的关联，并表征相关的促炎和抗炎标志物组。材料和方法共纳入 112 例患者的 324 例植入物。通过使用手动牙周探针或数字卡尺对种植体周围表型的以下组成部分进行临床测量：角化粘膜宽度 （PIKM-W）、粘膜厚度 （MT）、附着粘膜 （AM） 和前庭深度 （VD）。通过临床和影像学检查评估种植体周围炎和 PISTD 的存在。进行混合模型 logistic 回归分析以分析种植体周围表型与种植体周围炎或 PISTD 存在之间的关联，并调整相关混杂因素。采用多重免疫测定法评估一组促炎和抗炎标志物的种植体周围缝隙液水平。结果36.6% 、 21.4% 和 42% 的患者 （根据最差的植入物分类） 和 35.2% 、 34.3% 和 30.5% 的植入物分别诊断出种植体周围健康、种植体周围粘膜炎和种植体周围炎。在多水平多元回归模型中，不存在 PIKM-W （比值比 [OR] = 9.24;95% CI： 2.73–31.28）、无附着粘膜 （OR = 19.58;95% CI： 6.12–62.56） 和前庭深度减少 （<4 mm） （OR = 2.61;95% CI： 1.05–6.48） 与种植体周围炎相关。同样，不存在 PIKM-W （OR = 6.32;95% CI： 1.67–23.83）、粘膜薄 （<2 mm） （OR = 157.75;95% CI： 14.06–1769.9） 和前庭深度减少 （OR = 3.32;95% CI： 1.02–10.84） 与 PISTD 的存在相关。 PIKM-W = 0 mm 的植入物在常规 （≥2 次维护/年） 和不规则 （<2 维护/年） 遵守者 （p = 0.046 和 p = 0.012） 中显示出统计学上显着较高的干扰素-γ水平。在不规则依从者中，PIKM-W 的缺失也与白细胞介素 （IL）-1β 和 IL-21 水平的统计学显着升高相关 （p = 0.016，p = 0.046）。这些关联独立于相关混杂因素（例如，斑块、维护依从性等）的影响。结论在其限度内，目前的研究结果表明 （a） 种植体周围软组织表型似乎与种植体周围炎和 PISTD 的存在有关，并且 （b） 在没有 PIKM-W 的情况下，炎症反应似乎失调，软组织重塑上调。