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24 February 2023

The inflammatory profile in patients with cardiovascular disease affected by peri-implantitis

Lara Figini

Cardiovascular disease (CVD), the leading cause of mortality worldwide, is an umbrella term to describe a range of clinical heart and circulatory diseases.

Total cardiovascular disease, coined by the American Heart Association and encompassing coronary heart disease, heart failure, stroke and hypertension, has a prevalence of around 48% in adults.

There are several literature studies supporting the independent association between chronic oral infection and different chronic noncommunicable diseases, including CVD.

Materials and methods

In a study published in June 2022 in the Journal of Periodontology, the authors investigated pro-inflammatory cytokine profiles in patients with or without cardiovascular disease (CVD) and with or without peri-implantitis.

Serum, peri-implant crevicular fluid (PICF), and gingival crevicular fluid (GCF) were collected from patients with (n = 82) or without (n = 46) CVD at the site of the most severe peri-implantitis, including sites with periodontitis.

Proinflammatory molecules including high sensitivity C-reactive protein (hsCRP), fibrinogen, interleukin-1 beta (IL-1β), IL-6, plasma tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase 8 (MMP-8), osteoprotegerin (OPG), vascular endothelial growth factor (VEGF), IL-17, IL-8, tissue inhibitor of metalloproteinase-2 (TIMP-2), myeloperoxidase (MPO) and prostaglandin E2 (PGE2 ) were analyzed.

Researchers used the Kruskal-Wallis test to compare the groups. The diagnostic ability of each biomarker was evaluated using the chi-squared test and ROC analysis.


Serum IL-1β, TNF-α, and fibrinogen were significantly higher in patients with CVD than in those without. Serum fibrinogen showed a trend for higher concentration in patients with radiographic bone loss (RBL) ≥2 mm (P = 0.08).

TNF-α in the peri-implant crevicular fluid PICF showed a significantly higher level of detection in CVD patients and this coincides with local peri-implant inflammation. Furthermore, MMP8 in the PICF was significantly higher in sites with radiographic RBL bone loss ≥2 mm than in areas with healthy implants, while IL-1β, IL-8, MMP-8 and TIMP-2 were significant predictors for peri-implant disease.

TNF-α collected in gingival crevicular fluid from patients with periodontitis was significantly associated with CVD cases.


From the data of this study, it can be concluded that the increased expression of local and systemic proinflammatory cytokines found in the present study supports the possible association between chronic peri-implantitis with increasing severity and CVD. However, conclusive evidence is weak.

For more information: "Pro-inflammatory profiles in cardiovascular disease patients with peri-implantitis."

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