Composition of human peri-implantitis and periodontitis lesions

Abstract

The aim of the present study was to examine differences in cellular characteristics of human peri-implantitis and periodontitis lesions. Two groups of patients were included: 40 patients with generalized severe chronic periodontitis and 40 patients presenting with severe peri-implantitis. Soft tissue biopsies were obtained from diseased sites (probing pocket depth ≥ 7 mm with bleeding on probing) and prepared for histologic and immunohistochemical analysis. In contrast to periodontitis samples, peri-implantitis lesions were more than twice as large and contained significantly larger area proportions, numbers, and densities of CD138-, CD68-, and MPO-positive cells than periodontitis lesions. Peri-implantitis lesions also extended to a position that was apical of the pocket epithelium and not surrounded by noninfiltrated connective tissue. They further presented with significantly larger densities of vascular structures in the connective tissue area lateral to the infiltrated connective tissue than within the infiltrate. This study suggests that peri-implantitis and periodontitis lesions exhibit critical histopathologic differences, which contribute to the understanding of dissimilarities in onset and progression between the 2 diseases.

Keywords: biopsy; dental implant; immunohistochemistry; inflammation; inflammatory cell; peri-implant disease.

Figure 1.

Sections prepared from periodontitis and peri-implantitis sites. Pocket area located to the left. Haematoxylin and eosin, CD3, CD20, CD138, CD68, and MPO markers. Magnification x25 and x400.

Figure 2.

Percentage distribution of total number of cells in periodontitis and peri-implantitis lesions. CD3 (blue), CD20 (purple), CD138 (red), CD68 (brown), and MPO (green). Note the difference in size of infiltrated connective tissue (ICT). n = 80.