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Bone loss around oral and orthopedic implants: An immunologically based condition
Tomas Albrektsson1,2, William Becker3,4, Pierluigi Coli5
1Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden.
Clinical Implant Dentistry and Related Research
|May 29, 2019
Summary
Marginal bone loss around implants is not a disease but an immune response. This immune reaction, often temporary, protects implants but can threaten survival if it overreacts.
Area of Science:
- Biomaterials Science
- Immunology
- Dental Implantology
Background:
- Marginal bone resorption around implants is often misclassified as a disease, when it is typically a condition.
- Previous comparisons of oral implants to teeth are considered less relevant than comparing them to orthopedic implants.
Purpose of the Study:
- To compare oral implants with orthopedic implants.
- To re-evaluate the nature of marginal bone loss around implants.
Main Methods:
- This study is a narrative review.
- The review focuses on the reasons for marginal bone loss around implants.
Main Results:
- Oral and orthopedic implants are recognized as foreign bodies by the immune system.
- Bone formation (contact or distance osteogenesis) occurs to shield tissues from implants.
- A mild immune reaction and chronic inflammation can protect implants from bacteria.
Conclusions:
- Marginal bone loss is an immunologically driven rejection mechanism, not typically disease-related.
- Implant pathology is distinct from natural tooth or joint pathology.
- While immune overreaction can cause problems, most marginal bone loss is a temporary immune response that doesn't lead to failure.
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