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Aim: To monitor inflammation parameters around zirconia and titanium implants in comparison to the natural teeth during the development of experimental gingivitis/mucositis.
Methods: After 28 days of perfect oral hygiene 16 clinically profiled patients were asked to refrain oral hygiene for 14 days resulting in an experimental plaque accumulation, following 28 days with optimal plaque control. After collecting crevicular fluid samples at weeks 4, 5, 6, 7, 8, 9 and 10 around teeth and implants (zirconia and titanium) clinical, immunological and microbiological parameters were assessed. Immunological samples were analyzed for Tumor necrosis factor alpha (TNF alpha) and Interleukin-1β (IL-1β). Microbial samples were analyzed for Total bacterial cell number (TBCN) together with cell counts of bacterial species indicative for dysbiosis (Tannerella forsythia and Prevotella intermedia), applying quantitative real time PCR.
Results: A connection was confirmed between biofilm formation and soft tissue inflammation with a following recovery to baseline values. Compared with those of the zirconia and titanium implants, the TNF alpha and IL-1β values of the tooth showed a significant increase after reinstitution of oral hygiene. Around the tooth the lowest mean value of TBCN was measured, followed by zirconia implants and the highest numbers were found around titanium implants. In Tannerella forsythia positive samples, a significant lower count number around zirconium was measured compared to titanium. Prevotella intermedia sample showed a significant difference between groups (titanium vs. tooth).
Conclusions: Peri-implant soft tissues around zirconia implants developed a lower inflammatory response to experimental plaque accumulation when compared to titanium implants in terms of TBCN, Tannerella forsythia and Prevotella intermedia.
About Dr. Kniha:
Priv.-Doz. Dr. med. dent. Kristian Kniha started his residency for oral surgery in 2015 in the Department of Oral and Maxillofacial Surgery University Hospital of RWTH Aachen (Head & Chairman Frank Hölzle, M.D., D.M.D., Ph.D., FEBOMFS). In 2018 he was nominated to oral surgeon by the Zahnärztekammer Nordrhein. Additionally, in 2019 he received the Habilitation and Venia Legendi in oral surgery about the topic „Clinical use of zirconium dioxide implants for dental rehabilitation“ from the University Hospital of RWTH Aachen, Germany. Since 2021, he is working in the private clinic for oral and maxillofacial surgery, Kniha, Schlegel and colleagues in Munich, Germany.