Pusan National University researchers discover potential biomarkers for peri-implantitis

The number of people receiving dental implants is increasing annually, as more individuals become aware of the advantages of replacing missing teeth. However, this rise has also been accompanied by a growing prevalence of PI. While treatment protocols for PI often mirror those designed for managing periodontitis, they have proven to be less effective. Additionally, PI has a higher chance of recurrence than periodontitis, posing greater challenges for management.  

Understanding the key differences in the pathophysiology of PI and periodontitis is essential for developing more specialized and effective treatments for PI. A significant breakthrough in efforts to identify these critical differences was made in the study, which uncovered a link between PI and activated fibroblasts. Activated fibroblasts are cells in the connective tissue that have started to proliferate abnormally. The study also identified three specific marker genes that were overexpressed in PI but not in periodontitis. This paper was made available online on 1^st October 2024 and was published in Volume 151 of the Journal of Dentistry.

“This study provides essential insights into the role of activated fibroblasts as a distinctive factor in the pathogenesis of peri-implantitis versus periodontitis. Although peri-implantitis and periodontitis share clinical similarities, they exhibit distinct biological pathways. This research identifies three key biomarkers—ACTA2, FAP, and PDGFRβ—that are markedly overexpressed in peri-implantitis. These biomarkers have the potential to facilitate differential diagnosis and contribute to the development of peri-implantitis-specific therapeutic approaches”, explains Professor Yun Hak Kim, a lead researcher in the study.

To understand the genetic, immunological and other physiological factors underlying PI and periodontitis, researchers collected gingival tissue from patients having both conditions. The samples were then processed to sequenced, and analyzed RNA obtained from the gingival tissue. The study identified the three genes that could serve as disease-specific biomarkers for PI, which can help clinicians diagnose the condition and make more informed decisions regarding treatment.

Biomarker-based diagnostics could minimize misdiagnoses between peri-implantitis and periodontitis, thereby enhancing patient prognoses. By providing targeted treatment strategies for high-risk patients, particularly in peri-implantitis, this approach may contribute to reducing recurrence rates and improving overall therapeutic effectiveness. “These findings could drive significant advancements in clinical strategies for diagnosing and treating peri-implantitis,” notes Professor Kim.

While the treatment for periodontitis comprises of mechanical treatment to fix structural integrity of teeth and various antimicrobial treatments, PI treatment follows a similar protocol. Although controlling the disease with this approach is highly challenging. The differentially expressed genes identified in the study could be pivotal in developing new treatment approaches for PI that target its unique pathophysiology.

“Over the next 5-10 years, this study’s findings could serve as a fundamental basis for the development of highly specialized, targeted therapies addressing peri-implantitis, specifically focusing on its unique biological and immunological characteristics compared to periodontitis”, concludes Professor Kim. This targeted approach could significantly contribute to extending the durability and success rates of dental implants, especially for patients at elevated risk of peri-implantitis due to underlying inflammatory conditions. Additionally, by elucidating the role of activated fibroblasts in peri-implantitis, this research offers valuable insights that could advance our understanding and treatment of other chronic inflammatory diseases with similar cellular mechanisms.

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Reference

DOI: 10.1016/j.jdent.2024.105366

About the institute

Pusan National University, located in Busan, South Korea, was founded in 1946 and is now the No. 1 national university of South Korea in research and educational competency. The multi-campus university also has other smaller campuses in Yangsan, Miryang, and Ami. The university prides itself on the principles of truth, freedom, and service, and has approximately 30,000 students, 1200 professors, and 750 faculty members. The university is composed of 14 colleges (schools) and one independent division, with 103 departments in all.

Website: https://www.pusan.ac.kr/eng/Main.do

About the authors

Professor Yun Hak Kim is an associate professor in the Department of Anatomy at Pusan National University's School of Medicine. He serves as the head professor in the Department of Interdisciplinary Science of Genomic Science at PNU. His group utilizes cutting-edge technology to understand the pathophysiology of diseases and to discover therapeutic targets. The Kim group handles both experiments and bioinformatics, employing a multiomics approach that includes single-cell transcriptomics, spatial omics, genomics, epigenomics, and microbiomics to unravel the causes of complex diseases.

Lab Website: https://yunhakkim.pusan.ac.kr/

ORCID id: 0000-0002-9796-8266

Professor Jung-Min Oh is an associate professor in the Department of Oral Biochemistry at Pusan National University's School of Dentistry. Her lab studies DNA damage repair mechanisms within cells and the changes in gene expression in various diseases. The lab aims to understand how DNA damage is repaired and how gene expression changes in diseases, elucidating the connections between DNA damage response and the development and progression of various diseases.

Lab Website: https://dna.pusan.ac.kr/

ORCID id: 0000-0003-0385-7168

Professor Hyun-Joo Kim is an associate professor in the Department of Periodontology at Pusan National University's School of Dentistry. She provides highly specialized periodontal treatment to patients as a periodontist at the Department of Periodontics, Pusan National University Dental Hospital. Her researches aim to develop treatment methods based on the unique characteristics of diseases that can be applied to the practical field, utilizing clinical insights gained from daily management of periodontitis and peri-implantitis.

ORCID id: 0000-0001-7553-6289