Development of chair-side assay system for ongoing bone loss with peri-implant sulcus fluids

本研究的第一个目的是检测从种植体周围炎部位收集的笔式种植体龈沟液（PISF）中的MMP-1、MMP-8和MMP-13，并确定MMP存在/不存在与正在进行或未来的骨丢失之间的任何相关性。本研究纳入了4例种植体周围炎患者和4例匹配的对照患者。计算每年调整的垂直骨丢失（AVBL），以确定骨丢失的年速度。利用对MMP-1、MMP-8和MMP-13具有特异性的抗人单克隆抗体通过蛋白质印迹法分析PISF。在种植体周围炎患者组中，MMP-8在三个活动性种植体周围炎部位的PISF中检测到，其AVBL大于0.8 mm/年。同时，在其余6个种植体的PISF中未检测到MMP-8，其PISF采样时的AVBL小于0.6 mm/年。在对照组中，MMP-8在任何PISF中均未检测到。MMP-1和-13在所有PISF样本中均未发现。根据研究结果，明确了MMP-8可能是预测牙种植体周围持续骨丢失的良好标志物。下一个目标是使用多变量分析确定骨整合（SRO）临床成功率的风险因素。受试者为1990年2月至2007年3月在我院安装表面粗糙的牙种植体的连续患者。Logistic回归分析显示，没有预测变量是近期粗糙表面牙种植体发生SRO的危险因素。第三个目的是评估口腔健康相关的生活质量（OHQoL）水平治疗前后的部分无牙患者种植支持义齿，固定和可移动的部分义齿，并比较OHQoL为基础的治疗效果之间的治疗方式。这表明种植义齿比固定义齿和活动义齿更能改善患者的OHQoL水平。

The first aim of this study was to detect MMP-1, MMP-8 and MMP-13 in the pen-implant sulcular fluid (PISF) collected from peri-implantitis sites and to determine any correlations between the MMPs presence/absence and the ongoing or future bone loss. Four peri-implantitis and four matched control patients were included in this study. Annually adjusted vertical bone loss (AVBL) was calculated to determine the annual velocity of the bone loss. PISF was analyzed by Western blotting utilizing anti-human monoclonal antibodies specific for MMP-1, -8 and -13. In the group of peri-implantitis patients, MMP-8 was detected in the PISF from three active peri-implantitis sites whose AVBL were more than 0.8 mm per year. Meanwhile, MMP-8 was not detected in the PISF from the remaining six implants whose AVBL at PISF sampling was less than 0.6 mm per year. In the control patients, MMP-8 was not detected in any PISF. MMP-1 and -13 could not be found in any PISF samples. According to the findings, it was clarified that MMP-8 could be a good marker for predicting ongoing bone loss around dental implants. The next aim was to identify the risk factors in clinical success rates of osseointegration (SRO) using multivariate analysis. Subjects were consecutive patients who had been installed dental implants with rough surface in our hospital from February 1990 to March 2007. Logistic regression analysis showed that no predictor variables were risk factors for SRO with recent rough surface dental implants. The third aim was to assess oral-health-related QoL (OHQoL) levels before and after treatment in partial edentulous patients with implant-supported dentures, fixed and removable partial dentures and to compare OHQoL-based treatment effectiveness among those treatment modalities. This indicates that implant-supported dentures can improve the patients OHQoL level much higher than the fixed and removable restorations.