Effect of periimplantitis treatment on the chemiluminescent activity of neutrophilic granulocytes <i>in vitro</i>

BACKGROUND: Periimplantitis causes implant loss, which reduces the quality of dental treatment. The effect of periimplantitis treatment on the immune response, particularly the chemiluminescent activity of neutrophilic granulocytes, is unclear. The paper addresses this issue, as well as improvements in periimplantitis treatment approaches. AIM: To assess the biocompatibility of implants removed from the inflammation site and treated with Air Flow and laser. MATERIALS AND METHODS: Three types of implant surface were assessed: anodized titanium dioxide (TiO2); sand-blasted, large grit, acid-etched (SLA); and resorbable blast media (RBM). Implants were removed in patients with confirmed periimplantitis, followed by an air-powder abrasive surface treatment with Air Flow and chlorhexidine, using a YSGG laser with a wave length of 2,780 nm. New (out of the box) implants were used as a control. Biocompatibility was assessed by the synthesis of primary and secondary reactive oxygen species (ROS) by neutrophils; the intensity and kinetics of synthesis were examined using chemiluminescence analysis. RESULTS: Lucigenin- and luminol-dependent chemiluminescence of neutrophils was assessed following in vitro incubation with SLA, RMB, and TiO2 implants removed in patients with confirmed periimplantitis and treated with Air Flow and chlorhexidine. The study found a decrease in the time to maximum and an increase in the maximum intensity and area under the curve of spontaneous and zymosan-induced chemiluminescence of neutrophils, regardless of the studied implant type. Changes in the zymosan-induced chemiluminescence of neutrophils following incubation with implants were greater than changes in spontaneous chemiluminescence, resulting in a higher activation index. No significant changes in neutrophil chemiluminescence were observed after in vitro incubation with laser-treated SLA, RMB, and TiO2 implants. CONCLUSION: SLA, RMB, and TiO2 implants removed in periimplantitis patients and treated with Air Flow and chlorhexidine have low biocompatibility. However, Air Flow-treated RBM implants show relatively superior biocompatibility than SLA and TiO2 implants, which is attributed to the decreased synthesis of primary and secondary ROS by neutrophils during in vitro incubation. The degree of ROS synthesis by neutrophils during incubation with laser-treated implants corresponds to that of the control, indicating increased biocompatibility of laser-treated implants. Laser-treated TiO2 implants had the lowest neutrophil activation during incubation, determining their maximum biocompatibility among the studied implants.