Diagnostic potential of endothelin-1 in peri-implant diseases: a cross-sectional study

Abstract

Purpose: This study aimed to evaluate the potential of Endothelin-1 (ET-1), a peptide derived from vascular endothelial cells, as a biomarker for diagnosing peri-implant diseases.

Methods: A cohort of 29 patients with a total of 76 implants was included in this study and subsequently divided into three groups based on peri-implant clinical parameters and radiographic examination: healthy (peri-implant health) (n = 29), mucositis (n = 22), and peri-implantitis (n = 25) groups. The levels of ET-1 (ρg/site) and interleukin (IL)-1β (ρg/site) in peri-implant sulcus fluid (PISF) samples were determined using enzyme immunoassay. Statistical analyses were conducted using Kruskal-Wallis and Steel-Dwass tests. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic performance of the biomarkers.

Results: ET-1 levels were significantly elevated in the peri-implantitis group compared to those in the healthy group, and were highest in the peri-implant mucositis group. Additionally, IL-1β levels were significantly higher in the peri-implantitis group than those in the healthy group. ROC curve analysis indicated that ET-1 exhibited superior area under the curve values, sensitivity, and specificity compared to those of IL-1β.

Conclusions: Our findings suggest that the presence of ET-1 in PISF plays a role in peri-implant diseases. Its significantly increased expression in peri-implant mucositis indicates its potential for enabling earlier and more accurate assessments of peri-implant inflammation when combined with conventional examination methods.

Keywords: Endothelin-1; Interleukin-1β; Marginal bone loss; Peri-implant mucositis; Peri-implantitis.

Fig. 1

(a) Bone resorption measurement using radiographic images. The distance between the proximal bone junction and the most apical side of the implant was measured using the implant shoulder as a reference point. The resulting values were corrected by the magnification ratio to the long diameter of the implant body, and marginal bone loss (MBL) was calculated. (b) Formula for calculating average annual bone loss (ABL). The ABL around the implants was calculated in comparison to the MBL at the baseline. (c) The PISF was obtained using PerioPaper from the site where the PPD was deepest

Fig. 2

PISF volume in the healthy, mucositis, and peri-implantitis groups The median PISF volume was 1.45 µL in the healthy group, 3.28 µL in the mucositis group, and 4.15 µL in the peri-implantitis group. (*: p < 0.05, ** : p < 0.01, Kruskal–Wallis test, Steel–Dwass test)

Fig. 3

Biomarker expression in the healthy, mucositis, and peri-implantitis groups (a) The median values for ET-1 concentration were 0.17 × 10^− 3 pg/site in the healthy group, 1.02 × 10^− 3 pg/site in the mucositis group, and 0.47 × 10^− 3 pg/site in the peri-implantitis group. Between-group assessments showed significantly higher ET-1 expression in the mucositis (p < 0.01) and peri-implantitis (p < 0.05) groups compared to that in the healthy group (b) The median values of IL-1β concentration were 0.03 µg/site in the healthy group, 0.15 µg/site in the mucositis group and 0.08 µg/site in the peri-implantitis group. The IL-1β levels in the peri-implantitis group were significantly higher than those in the healthy group (p < 0.01). (*: p < 0.05, **: p < 0.01, Kruskal–Wallis test, Steel–Dwass test)

Fig. 4

(a and b) Receiver operating characteristic (ROC) analysis showing the diagnostic ability of ET-1 and IL-1β to differentiate healthy groups and peri-implantitis: (a) univariable (n = 54), (b) adjusted for gender, age (n = 54), (c and d) ROC analysis showing the diagnostic ability of ET-1 and IL-1β to differentiate individuals in the healthy and peri-implant mucositis groups: (c) univariable (n = 51), (d) adjusted for gender, age (n = 51)