STEP

Sensing peri-implant disease

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 Obiettivo del progetto (Objective)

'Peri-implant disease is a true threat in today’s advancement of implant reliability and performance. The diagnostic approach followed in this grant is for early recognition of peri-implant diseases. Our System is sensing Matrix metalloproteinase 8 (MMP-8) regulation indicative for connective tissue degradation as present at the borderline of gingivitis/mucositis and periodontitis/peri-implantitis. We detect risk factors at the earliest possible moment directly facing today’s challenge in dental implantation successes: The delayed recognition of peri-implant complications which are typically recognized only once clinical signs appear - a stage at which the disease course may be irreversible and lasting complications may prevail at the site of the implant zone. Consequently, the proposed system is designed to allow on-demand, self monitoring with the subject / patient providing surveillance of the peri-implant disease status. It is this patient-supported surveillance which upon report by the patient will allow the dentist to diagnose at an early disease state, potentially allowing relatively easy treatment modalities and as compared to the harsher approaches typically required at later stages. The 'monitoring device' for the proposed system is the human tongue. The diagnostic approach is deploying a protease / MMP-8 sensitive peptide sequence, coupled to a flavoring substance. This platform is (i) either coupled to the superior (cranial) aspect of a dental implant or (ii) to spheres, which in return are formulated into a chewing gum. In response to elevated MMP-8 levels as an early signs of peri-implant disease (MMP-8 is highly predictive for peri-implant diseases) the flavoring substance is released and sensed by the patient's gustatory system. It is this self-monitoring which we believe renders the system truly disruptive and radically opens novel opportunities for early diagnosis and treatment modalities of peri-implant disease.'

Introduzione (Teaser)

Peri-implant disease poses a threat to the successful outcome of dental implants. European researchers are constructing a novel system to detect peri-implant complications early on to ensure implant reliability and performance.

Descrizione progetto (Article)

Often after dental implantation, inflammatory lesions appear around the implant fixtures. Peri-implant complications are typically recognised only after clinical signs appear and require harsh treatment modalities.

The aim of the EU-funded 'Sensing peri-implant disease' (http://www.step.uni-wuerzburg.de/ (STEP)) project is to develop a novel assay that can detect biomarkers associated with early stages of peri-implant disease. Project efforts are concentrated on matrix metalloproteinase 8 (MMP-8), a biomarker indicative of connective tissue degradation, which occurs just before the onset of peri-implant disease.

The 'monitoring device' for the proposed system is the human tongue. The diagnostic approach is deploying a molecule that will react with MMP-8 and is coupled to a flavouring substance, all formulated into a chewing gum. In the presence of MMP-8, the flavouring substance is released and the patient can self-monitor a gustatory change linked to the peri-implant disease status.

Currently researchers are screening a library of nearly 250 molecules for biomarker sensitivity. They are also performing a clinical trial to correlate the measured biomarker in human fluids at different stages of periimplantitis. Preliminary results indicate a strong correlation of disease stage to biomarker concentration, validating the approach of this novel assay.

To provide evidence that the biomarker levels are due to inflammation in transmucosal dental implants, partners are performing experiments in a pre-clinical model of mini-pigs. Additional analyses of the peri-implant hard and soft tissue will reveal the histological changes associated with the early stages of peri-implant disease.

The STEP self-checking approach is expected to improve prompt diagnosis and thereby enrich current treatment modalities. The system could find application in the diagnosis of device-related complications and infections.