Elastase, alpha2-macroglobulin and alkaline phosphatase in crevicular fluid from implants with and without periimplantitis.

The aim of this investigation was to determine the presence of selected enzymes and enzyme inhibitors in crevicular fluid collected from implants with and without clinical, radiographic and microbiological signs of periimplantitis. Eleven implants with symptoms of periimplantitis in eight patients (four men and four women) were compared to eleven implants in seven subjects (one man and six women) without periimplantitis. Periimplant crevicular fluid (PICF) was collected at the mesial and distal sites of each implant. Alkaline phosphatase activity (ALP) was measured by using p-nitrophenyl-phosphate as substrate, elastase activity (EA) by the use of a low molecular weight fluorogenic substrate, and the inhibitor alpha2-macroglobulin (alpha2M) by ELISA. ALP, EA and alpha2M were detected in the majority of samples in both groups. In comparison to the clinically healthy implants, total amounts of each of these substances were significantly higher in PICF collected around implants with periimplantitis. The mean total amounts of EA, alpha2M and ALP in the healthy group were: EA: 1.8 ng, alpha2M: 3.1 ng, ALP: 24.1 U, and in the periimplantitis group EA: 23.1 ng, alpha2M: 25.2 ng and ALP: 142.3 U. In addition, all three mediators were correlated with the clinical parameters. The results confirm the similarity of the inflammatory response of tissues surrounding implants and natural teeth, and suggest that ALP and EA could be promising markers of bone loss around dental implants.