The Effect of Platform Switching on Periimplant Crevicular Fluid Content During Early Wound Healing

Low-level laser therapy on soft tissue healing after implantation: a randomized controlled trial

BACKGROUND

To explore the effect of low-level laser therapy (LLLT) on the healing of soft tissue around the implant after flap implantation and explore the possible mechanism.

METHODS

A total of 58 patients who underwent implant surgery were enrolled, with a total of 70 implants. They were randomly divided into the LLLT group and the control group. The LLLT group underwent LLLT with Nd:YAG (Fotona, 1064 nm) immediately after surgery and on the 2nd and 3rd day in the surgical area, while the control group did not receive any intervention. Pain assessment was performed in the first 3 days after surgery. The weight of peri-implant crevicular fluid (PICF), modified sulcus bleeding index (mSBI), gingival index (GI), and the expression levels of tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF) on the 7th and 14th days after surgery were evaluated.

RESULTS

On the first 3 days after surgery, the pain score of the LLLT group was significantly lower than that of the control group. On the 7th and 14th day after surgery, the PICF volume, mSBI, GI, and TNF-α levels of the LLLT group were lower than those of the control group. The VEGF levels in the LLLT group were significantly higher than that in the control group.

CONCLUSIONS

LLLT can promote the healing of the soft tissue after implantation, effectively relieve postoperative pain, improve clinical indicators, reduce TNF-α, and increase the expression level of VEGF, which is worthy of clinical application.

TRIAL REGISTRATION

Retrospectively Registered Trials ChiCTR2400087562 (07/30/2024).

Analysis of Biomarkers and Marginal Bone Loss in Platform-Switched and Nonplatform-Switched Implants: A Randomized Clinical Trial

Objectives. To compare the peri-implant crevicular fluid (PICF) biomarker levels, peri-implant status, and marginal bone level (MBL) differences of implants restored with randomly assigned nonplatform-switched (NPS) or platform-switched (PS) abutments. Methods. Ninety-four implants in 27 subjects were included in this study. Receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin-1β (IL-1β), monocyte chemotactic protein-1 (MCP-1) levels in PICF, peri-implant health, and the change in the MBL were evaluated at the time of restoration ( $T_1$ ) and after 12 months ( $T_2$ ). Results. The IL-1β levels decreased and the RANKL, OPG, and MCP-1 levels increased from $T_1$ to $T_2$ ( $P<0.05$ ) in both groups. RANKL/OPG ratio at $T_1$ , MCP-1 levels at $T_2$ , and the MCP-1 change from $T_1$ to $T_2$ were lower in the PS group than in the NPS group ( $P<0.05$ ). MBL change was lower ( $0.51\pm 0.31$  mm) in the PS group than that ( $0.75\pm 0.29$  mm) in the NPS group at $T_2$ ( $P<0.001$ ). Peri-implant health status between the study groups was negligible. Conclusion. PS was superior to NPS regarding the preservation of MBL. Higher MCP-1 levels, altered RANKL/OPG ratio, and lower OPG levels in the NPS group could be associated with subclinical peri-implant bone remodeling.

Soft tissue healing around platform-switching and platform-matching single implants: A randomized clinical trial

BACKGROUND

Implants with platform-switching (PS) design have been demonstrated to reduce marginal bone loss. However, the influence on peri-implant soft tissue healing is unclear. This study was designed to investigate its effect on peri-implant soft tissue healing after implant uncovery.

METHODS

Non-smokers needing two implants in different quadrants were recruited in this study. For each individual, one PS and one platform-matching (PM) implants were placed using two-stage protocol. Following 2 to 8 months of healing, all implants were uncovered and connected to the corresponding healing abutments. Clinical measurements and peri-implant crevicular fluid (PICF) were taken at 1-, 2-, 4-, and 6-week after 2nd stage surgery. The cytokine concentrations in PICF were analyzed. Peri-implant mucosa (1 × 2 × 2 mm) was harvested around the healing abutment for the analysis of gene expression at uncovery and 6-week post-uncovery.

RESULTS

Eighteen participants (nine males; 51.7 ± 14.9 years) were recruited. Compared to PM, PS showed significantly lower probing depth (PD) at 1- and 2-week as well as modified sulcus bleeding index (mSBI) at 1-, 4-, and 6-week (P < 0.05). Over time, a decrease in osteoprotegerin and interleukin-1β concentrations in PICF along with an increase in receptor activator of unclear factor kappa-B ligand, periostin, and peroxidasin gene expressions in peri-implant mucosa were noted within both groups (P < 0.05) without significant intergroup differences.

CONCLUSION

Within the limits, implants with PS design rendered significant benefits over PM design in PD and mSBI reduction during a 6-week healing. However, molecular changes within PICF and peri-implant mucosa as a response to PM and PS appear negligible.