Advanced biomaterials regulating mitochondria for treatment of peri-implantitis

Peri-implantitis is a pathogenic disease post-dental implantation, which is initiated by plaque accumulation and coupled with the dissemination of Ti or TiO₂ particles. The inflammatory cascade in the proximity of the implant ultimately results in implant failure. Recent studies have revealed that mitochondrial dysfunction is closely linked to the onset and progression of peri-implantitis, especially its inflammatory reactions. In addition, the complicated nature of the environment surrounding the implant requires a more comprehensive treatment strategy. In this review, we summarize the mitochondrial disruption in the pathogenesis of peri-implantitis and discuss some advanced biomaterials that present therapeutic effects on peri-implantitis. Recent studies concerning the disruption of mitochondria from sterile and microbial inflammation including mitochondrial reactive oxygen species production, quality control, structure, and metabolic status are summarized. Furthermore, biomaterials targeting peri-implantitis are discussed, most of which focus on the regulation of mitochondrial dysfunction, P. gingivalis elimination, immunoregulation, and/or a comprehensive modulation of effective factors. Understanding mitochondrial dysfunction in peri-implantitis is beneficial to inspire new research directions for the pathological intervention and treatment of peri-implantitis. The design, effective factors, therapeutic outcome, and underlying mechanism of these biomaterials would also inspire the future development of therapeutic strategies.