An In-Vivo Comparative Evaluation and Role of MMP-1 (Matrix Metalloproteinase) and RANKL (Receptor Activator of Nuclear Factor Kappa-B Ligand) Biomarkers in Peri-Implant Crevicular Fluid (PICF) For Bone Remodelling & Peri-Implantitis with their Direct Cor

Abstract

Abstract

Aim: This study aims to evaluate the role of MMP-1 (matrix metalloproteinase) and RANKL (receptor activator of nuclear factor kappa-b ligand) biomarkers in peri-implant crevicular fluid (PICF) for bone remodelling & peri-implantitis with their direct correlations with primary stability and success of implants in flapless implant surgeries

Materials and Methods: Forty patients with a missing right mandibular first molar sought replacement. Thirty patients chose implants and implant-supported prostheses, aged 25 to 50, after screening for mental issues, smoking, and systemic diseases. Following informed consent and CBCT analysis, implants were placed under anaesthesia, with healing abutments added after two months. Sutures were removed a week later, and oral hygiene instructions were provided. An implant-supported prosthesis was placed in the third month, and peri-implant crevicular fluid samples were collected by the fifth month. The patients were divided into two groups: Group 1 analysed MMP-1 levels, and Group 2 assessed RANKL levels using the ELISA test, with primary stability measured by the Perio test system. Group 1 focused on MMP-1 in inflammation and tissue remodelling, while Group 2 examined RANKL in osteoclast genesis and bone resorption.

Statistical Analysis and Results: This study, analysed using SPSS software, involved 30 patients (16 males, 14 females and aged 25-50) seeking dental implants for a missing maxillary right central incisor. Participants underwent a Cone Beam Computed Tomography (CBCT) scan, followed by immediate implant placement and a two-month healing period. By the third month, implant-supported prostheses were completed. Five months post-implantation, peri-implant crevicular fluid (PICF) samples were analysed for inflammation markers using ELISA. In Group 1 (n=15), MMP-1 levels were 0.1-1.0 pmol/L, with 9 showing elevated levels. Group 2 (n=15) had RANKL levels of 450-800 pg/mL, with 10 elevated. Stability assessment revealed that 5 patients in Group 1 and 4 in Group 2 had stability under 1. A one-way ANOVA was used for comparative analysis among the groups.

Conclusion: This study concluded that RANKL and MMP-1 are essential biomarkers for assessing bone remodeling and peri-implantitis, with RANKL showing a stronger correlation and potential as a more reliable indicator. Both biomarkers provide insights into disease progression, though their predictive effectiveness may vary by context. Future research is needed to refine their clinical applications.