| dc.description.abstract | Aims and Objectives: The aim of this pilot study was to describe the protein expression during the early and late stage of osseointegration in the peri-implant crevicular fluid (PICF) of a cohort of post-menopausal osteoporotic women. The primary objective was to explore and compare targeted protein expression in PICF during early days of healing (7 days) and once osseointegration and loading had already been achieved (6 months post loading) in a cohort of post-menopausal osteoporotic women. The secondary objectives were to determine if inflammatory and bone related markers in PICF correlate with bone mineral density (T-score), use of osteoporosis medications in osteoporotic patients, smoking status or post-operative adverse events (e.g. swelling and pain). Material and methods: PICF samples of 9 patients were collected at visit 4 (7 days following implant placement) and visit 7 (6 months following loading of the implant) and quantitatively analysed for changes in the expression of pre-determined protein markers using LUMINEX multiplex bead array assays. The difference in the expression of PICF between the two time points was assessed with the Wilcoxon signed rank test (p<0.05), while the correlation between marker expression, bone mineral density, use of osteoporosis medications and post operative adverse events was explored through the Spearman rank correlation coefficient. Results: Inflammatory markers were overall downregulated between visit 4 and visit 7, with CCL18 demonstrating statistical significance. IL1-Α was the only inflammatory marker showing a non-statistically significant increase. A non-statistically significant reduction in VEGF and BMP-2 levels was also observed. Other markers such as osteopontin, osteoprotegrin and BMP9 were not detected in the PICF. A statistically significant negative correlation (-0.8, p=0.006) between ‘no history of periodontal therapy’ and CCL2 levels was observed at visit 4. A statistically significant negative correlation (-0.7, P value=0.014) between no previous periodontal therapy and BMP2 levels was also at visit 4. At visit 4, T score was also negatively correlated (-0.8, p value=0.03) with BMP2 levels. Conclusion: This is a pilot study reporting for the first time on the expression of targeted inflammatory and bone metabolism PICF proteins at early (visit 4) and late stages (visit 7) of healing during osseointegration in osteoporotic post-menopausal women. The overall reduced expression of inflammatory markers (although not significant) between the early and late stages of healing confirm the current knowledge on the biology of osseointegration. Similarly, the non-significant reduction in the values of markers related with bone matrix deposition, angiogenesis, maturation, and remodelling markers at 6 months post loading were anticipated. There was an unexpected non-statistically significant increase for IL1-Α at 6 months post loading, which may be related to the limited population sample or high inter-individual variability. Future studies in a larger population sample and with more time-points are warranted to provide a wider range of data and increased accuracy. | en_US |
