Neutrophil response and microbiological findings around teeth and dental implants

The aim of this study was to compare the neutrophil response, measured as both functional and antigenic elastase, around teeth and titanium implants and to relate these findings to the microbiota. The 31 patients included in the study had been treated successfully for total or partial edentulism with titanium implants. Crevicular fluid and microbiological samples were taken from 3 sites: 1) crevices around teeth and 2) implants in 16 partially edentulous patients and 3) crevices around implants in 15 edentulous patients. All sites sampled showed similar degrees of inflammation assessed by gingival index and total protein concentration. The samples were analyzed for elastase activity and immunoreactive elastase. The elastase activity was significantly higher in crevices surrounding implants in partially edentulous patients compared with implants in edentulous patients. The antigenic elastase showed no difference among the 3 sites. Gram-positive cocci were the main bacterial species in all 3 groups. Edentulous patients tended to have lower frequency of black pigmenting anaerobes. No correlation of analyzed bacteria and elastase activity was found between the 3 sites. This study indicates that, despite a similar appearance of clinical parameters and absence of significant differences in the microbiota, the inflammation around implants in partially edentulous patients induces a stronger neutrophil response than does the inflammation around implants in edentulous patients.