Algorithm for the diagnosis of Helicobacter pylori with peri-implantitis

Abstract

The leading etiologic factor in the development of peri-implantitis is microorganisms, which, due to the development of the infectious process, cause resorption of bone tissue directly adjacent to the implant, followed by its disintegration and removal. The aim of this study was to develop reliable and informative algorithms for diagnosing the development of peri-implantitis, which will maximally include safe and affordable methods. Objects and methods. Patients aged 20 to 48 years were examined, with a partial secondary edentia. All patients were randomly divided into two groups, comparable by demographic, nosological indicators. The first group consisted of 248 patients with osseointegrated implants, the second group consisted of 26 individuals which based on examination of the clinical picture and the results of X-ray, verified the diagnosis of peri-implantitis. A phased examination was conducted. To determine antibodies to Helicobacter pylori in the saliva, the diagnostic immunochromatographic membrane test method of the test cassette was used in patients of both groups in accordance with the method proposed by the authors. The second stage was the cytological examination of the contents from the bone cavity after removal of the implant and the third stage was the release of Helicobacter pylori DNA in the saliva. Results and discussion. A detailed result of analysis of patient’s examination made it possible to establish the following. Parameters of antibodies to HP in the saliva during the immunochromatographic test revealed the presence of antibodies to HP in 37 (15%) patients of the first group with osseointegrated implants and in 26 (100%) patients of the second group with peri-implantitis. The microbiological composition in the cytological study with peri-implantitis is presented: mixed and coccal flora in 4 patients (10%), fungi in 3 patients (11%), Helicobacter pylori in 24 patients (93%), lymphoid elements, erythrocytes and leukocytes in 26 patients (100%). A comparative evaluation of the results of the polymerase chain reaction in patients of the two groups showed that a positive result (the presence of Helicobacter pylori DNA) in the first group was detected in 20 patients — 23% of the observations. In the second group, a positive PCR test was determined in 26 patients, which was 100% of the observations. Each of the laboratory methods for detecting HP has its advantages and disadvantages, as well as its sensitivity and specificity. Numerous comparative studies have shown that the results obtained using different methods are not always identical. In this case, the result should be considered positive or negative when the indicators of all applied methods of research coincide. Conclusion. The obtained results are the basis for the conclusion about the presence of a definite relationship of the pathological inflammatory process in the bone tissue of the jaw directly adjacent to the dental implant and the character of Helicobacter pylori carriage in the observed patients.