Diagnostic accuracy of bone-related biomarkers on peri-implantitis: potential of A-proliferation-inducing ligand

Abstract Objective To study the biomarker profile in peri-implant crevicular fluid (PICF) of A proliferation-inducing ligand (APRIL), receptor activator of nuclear factor κβ (RANKL) and interleukin (IL)-23, in healthy, periimplant mucositis and peri-implantitis sites, and to explore their diagnostic...

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Main Authors: Alejandra Chaparro, Valeria Ramírez, María José Bendek, José Nart, Alberto Monje, Andrés Pascual, Carolina Rojas, María Luisa Mizgier, Daniela Albers, Víctor Beltrán
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06578-y
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author Alejandra Chaparro
Valeria Ramírez
María José Bendek
José Nart
Alberto Monje
Andrés Pascual
Carolina Rojas
María Luisa Mizgier
Daniela Albers
Víctor Beltrán
author_facet Alejandra Chaparro
Valeria Ramírez
María José Bendek
José Nart
Alberto Monje
Andrés Pascual
Carolina Rojas
María Luisa Mizgier
Daniela Albers
Víctor Beltrán
author_sort Alejandra Chaparro
collection DOAJ
description Abstract Objective To study the biomarker profile in peri-implant crevicular fluid (PICF) of A proliferation-inducing ligand (APRIL), receptor activator of nuclear factor κβ (RANKL) and interleukin (IL)-23, in healthy, periimplant mucositis and peri-implantitis sites, and to explore their diagnostic accuracy on periimplantitis (PI) diagnosis. Materials and methods An exploratory cross-sectional study was conducted. Sociodemographic and clinical were recorded. Implant diagnosis was made based on the latest classification consensus. PICF samples were collected with paper strips from healthy, mucositis and PI implants. The biomarkers were analyzed by Luminex assay. The diagnostic accuracy was determined through sensitivity, specificity, predictive values (PV), and receiver operating characteristic (ROC) curves. Results Overall, 54 patients were recruited; 17 were healthy implants, 19 with mucositis and 18 have PI. RANKL and APRIL levels in PICF were significantly increased in PI implants compared to healthy implants (p < 0.001 and p = 0.005). IL-23 did not present differences between groups (p > 0.05). Positive correlations between PICF-RANKL levels and clinical attachment loss, plaque index score and bleeding on probing were observed (rho = 0.33; rho = 0.35; rho = 0.33; p < 0.05, respectively). Additionally, PICF-IL-23 and APRIL were correlated with the plaque index score and peri-implant probing depth (rho = 0.28; rho = 0.28, p < 0.05). PICF-APRIL concentrations and plaque index score were associated with PI (OR:3.01; 95%CI [1.08–8.38], p = 0.035, and OR:11.24; 95% CI [2.63–48.16], p = 0.001, respectively). The regression model, which included PICF-APRIL and plaque index, showed an AUC-ROC of 0.95, a sensitivity of 94.4%, 83.3% specificity, a positive PV of 73.9%, and a negative PV of 96.8%. Conclusions Implants with PI have higher levels of APRIL and RANKL in PICF compared to healthy implants. The model that includes the levels of APRIL in PICF combined with the plaque index score leads to an enhanced accuracy of PI diagnosis. Clinical relevance: Clinical diagnosis of peri-implant disease can be improved with molecular tools, in this case, APRIL demonstrated high accuracy for the diagnosis of PI.
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spelling doaj-art-2f3968619fa542b082610f558191c8172025-08-20T03:06:10ZengBMCBMC Oral Health1472-68312025-07-0125111010.1186/s12903-025-06578-yDiagnostic accuracy of bone-related biomarkers on peri-implantitis: potential of A-proliferation-inducing ligandAlejandra Chaparro0Valeria Ramírez1María José Bendek2José Nart3Alberto Monje4Andrés Pascual5Carolina Rojas6María Luisa Mizgier7Daniela Albers8Víctor Beltrán9Department of Oral Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los AndesDepartment of Sciences and Research, Epidemiology and Statistics, Faculty of Dentistry, Universidad de Los AndesDepartment of Oral Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los AndesDepartment of Periodontology, School of Dentistry, Universitat Internacional de CatalunyaDepartment of Periodontology, School of Dentistry, Universitat Internacional de CatalunyaDepartment of Periodontology, School of Dentistry, Universitat Internacional de CatalunyaDepartment of Oral Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los AndesDepartment of Oral Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los AndesDepartment of Oral Pathology and Conservative Dentistry, Faculty of Dentistry, Universidad de Los AndesClinical Investigation and Dental Innovation Center (CIDIC), Dental School, Center for Translational Medicine, Universidad de La FronteraAbstract Objective To study the biomarker profile in peri-implant crevicular fluid (PICF) of A proliferation-inducing ligand (APRIL), receptor activator of nuclear factor κβ (RANKL) and interleukin (IL)-23, in healthy, periimplant mucositis and peri-implantitis sites, and to explore their diagnostic accuracy on periimplantitis (PI) diagnosis. Materials and methods An exploratory cross-sectional study was conducted. Sociodemographic and clinical were recorded. Implant diagnosis was made based on the latest classification consensus. PICF samples were collected with paper strips from healthy, mucositis and PI implants. The biomarkers were analyzed by Luminex assay. The diagnostic accuracy was determined through sensitivity, specificity, predictive values (PV), and receiver operating characteristic (ROC) curves. Results Overall, 54 patients were recruited; 17 were healthy implants, 19 with mucositis and 18 have PI. RANKL and APRIL levels in PICF were significantly increased in PI implants compared to healthy implants (p < 0.001 and p = 0.005). IL-23 did not present differences between groups (p > 0.05). Positive correlations between PICF-RANKL levels and clinical attachment loss, plaque index score and bleeding on probing were observed (rho = 0.33; rho = 0.35; rho = 0.33; p < 0.05, respectively). Additionally, PICF-IL-23 and APRIL were correlated with the plaque index score and peri-implant probing depth (rho = 0.28; rho = 0.28, p < 0.05). PICF-APRIL concentrations and plaque index score were associated with PI (OR:3.01; 95%CI [1.08–8.38], p = 0.035, and OR:11.24; 95% CI [2.63–48.16], p = 0.001, respectively). The regression model, which included PICF-APRIL and plaque index, showed an AUC-ROC of 0.95, a sensitivity of 94.4%, 83.3% specificity, a positive PV of 73.9%, and a negative PV of 96.8%. Conclusions Implants with PI have higher levels of APRIL and RANKL in PICF compared to healthy implants. The model that includes the levels of APRIL in PICF combined with the plaque index score leads to an enhanced accuracy of PI diagnosis. Clinical relevance: Clinical diagnosis of peri-implant disease can be improved with molecular tools, in this case, APRIL demonstrated high accuracy for the diagnosis of PI.https://doi.org/10.1186/s12903-025-06578-yPeri-implantitisBiomarkersPeri-implant crevicular fluidMolecular diagnosis
spellingShingle Alejandra Chaparro
Valeria Ramírez
María José Bendek
José Nart
Alberto Monje
Andrés Pascual
Carolina Rojas
María Luisa Mizgier
Daniela Albers
Víctor Beltrán
Diagnostic accuracy of bone-related biomarkers on peri-implantitis: potential of A-proliferation-inducing ligand
BMC Oral Health
Peri-implantitis
Biomarkers
Peri-implant crevicular fluid
Molecular diagnosis
title Diagnostic accuracy of bone-related biomarkers on peri-implantitis: potential of A-proliferation-inducing ligand
title_full Diagnostic accuracy of bone-related biomarkers on peri-implantitis: potential of A-proliferation-inducing ligand
title_fullStr Diagnostic accuracy of bone-related biomarkers on peri-implantitis: potential of A-proliferation-inducing ligand
title_full_unstemmed Diagnostic accuracy of bone-related biomarkers on peri-implantitis: potential of A-proliferation-inducing ligand
title_short Diagnostic accuracy of bone-related biomarkers on peri-implantitis: potential of A-proliferation-inducing ligand
title_sort diagnostic accuracy of bone related biomarkers on peri implantitis potential of a proliferation inducing ligand
topic Peri-implantitis
Biomarkers
Peri-implant crevicular fluid
Molecular diagnosis
url https://doi.org/10.1186/s12903-025-06578-y
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