Immunologische Aspekte der periimplantären Wundheilung beim Sofortimplantat im Vergleich zum freigelegten, verzögert gesetzten Implantat

Objective: Aim of the study was to investigate differences between the wound healing patterns of provisionally restored immediate implants in comparison to delayed implants at 2nd stage surgery on a molecular immunological basis. Patients and Methods: In 36 implants (Replace, Nobel Biocare) of 21 individuals (10 men and 11 women; mean age 53, range 33 - 84 years) the gingival crevicular fluid (GCF) flow rate, and sulcular concentrations of neutrophil elastase (NPE) and interleukin-1 beta (IL-1 beta) were assessed at four time points. Nine implants hade been placed according to a delayed placement protocol and were supplied with titanium healing abutments on re-opening two days before the onset of the study. The remaining 26 implants were placed as immediate implants directly following tooth extraction, and were restored with provisional acrylic single crowns the same day. In the immediate implants group the first samples were taken prior to tooth extraction. Three follow-up visits were scheduled over the first four weeks after surgery in both groups. Results: IL-1 beta showed statistically significant lower concentrations in the immediate implants group as compared to the control group of delayed implants over the entire follow-up period. The levels for GCF flow rate and NPE were also notably lower than in the control group, but not on a statistically significant level. Conclusions: The results of this preliminary pilot investigation point at different wound healing characteristics between immediately and delayed implants for the findings investigated. Immediate implants with immediate acrylic provisional restorations seem to exhibit a less pronounced peri-implant inflammatory reaction than delayed implants restored at second stage surgery with titanium healing abutments. Keywords: Sofortimplantat, Spätimplantat, Wundheilung, Interleukin-1, neutrophile Elastase