Role of fibroblast populations in peri-implantitis

Int J Oral Maxillofac Implants. 2009 Mar-Apr;24(2):197-204.


Purpose: To understand the contribution of stromal cells, such as granulation tissue fibroblasts, to peri-implantitis with regard to (1) the secretion of constitutive factors promoting migration/survival of infiltrates into osseointegrated sites; and (2) the effect of exogenous infiltrate cytokines on the cells' secretion.

Materials and methods: Fibroblasts were cultured from eight peri-implantitis sites. Multiplexed enzyme-linked immunosorbent assay was used to quantify factors secreted by the cells either unstimulated or stimulated with gamma interferon (IFN gamma), interleukin 4 (IL4), or tumor necrosis factor alpha (TNF alpha). Controls consisted of fibroblasts cultured from healthy gingival and chronic periodontitis granulation tissues.

Results: Peri-implantitis fibroblasts differed significantly from periodontitis fibroblasts in their reduced secretion of the collagen inducer transforming growth factor beta-1 (TGF beta 1) and tissue inhibitor of metalloproteinase-1. The cells exhibited enhanced secretion of angiogenic factor vascular endothelial growth factor (VEGF) and collagenolytic matrix metalloproteinase 1 (MMP1) compared to both healthy and periodontitis fibroblasts. Fibroblasts from both periodontitis and peri-implantitis sites exhibited a pronounced proinflammatory profile compared to normal gingival fibroblasts with respect to secretion of chemokines IL6, IL8, and monocyte chemoattractant protein 1 (MCP1). Fibroblasts stimulated with TNF alpha showed increased levels of IL6, IL8, MCP1; neutrophil chemokine growth-related oncogene alpha stimulation with IFN gamma increased MCP1; and stimulation with IL4 increased VEGF.

Conclusion: The results indicate that peri-implantitis fibroblasts represent a distinct stromal population. The cells might participate in the pathogenesis of peri-implantitis by up-regulating both vascularity and matrix breakdown, thus promoting migration/maintenance of infiltrates into the site. Cytokines produced by infiltrates could enhance the inflammatory nature of the cells in a self-feeding loop.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Cells, Cultured
  • Chemokines / immunology
  • Chemokines / metabolism
  • Dental Implants / adverse effects*
  • Fibroblasts / classification
  • Fibroblasts / cytology*
  • Fibroblasts / immunology
  • Fibroblasts / metabolism
  • Gingiva / cytology
  • Gingiva / immunology
  • Humans
  • Periodontitis / etiology
  • Periodontitis / immunology
  • Periodontitis / pathology*
  • Reference Values
  • Tissue Inhibitor of Metalloproteinase-1 / immunology
  • Tissue Inhibitor of Metalloproteinase-1 / metabolism*
  • Transforming Growth Factor beta1 / immunology
  • Transforming Growth Factor beta1 / metabolism*
  • Vascular Endothelial Growth Factor A / immunology
  • Vascular Endothelial Growth Factor A / metabolism


  • Chemokines
  • Dental Implants
  • Tissue Inhibitor of Metalloproteinase-1
  • Transforming Growth Factor beta1
  • Vascular Endothelial Growth Factor A