Peri-implantitis pathogenesis: Novel insights may guide therapeutic interventions

Area of Science:

• Dental Implantology
• Biomaterials Science
• Immunology

Background:

• Dental implants can trigger inflammation due to metal particles and ions.
• Peri-implant mucositis and peri-implantitis are inflammatory conditions around implants.

Purpose of the Study:

• To review etiologic factors of peri-implantitis, focusing on foreign body responses.
• To suggest preventative and therapeutic strategies for metal particle-induced inflammation.

Main Methods:

• Literature review of factors contributing to peri-implantitis.
• Discussion of histology, treatments, prevention, and maintenance strategies.

Main Results:

• Bacterial biofilm is a primary cause, but foreign materials like cement and metal particles (metallosis) also contribute significantly.
• Metallosis, involving an immunoinflammatory cascade from implant debris, leads to bone loss.
• Minimally invasive techniques and stringent hygiene can help manage foreign particle burden.

Conclusions:

• Understanding peri-implantitis etiology is evolving, with metallosis being an increasingly recognized factor.
• Simple treatment adaptations to reduce metallosis should be integrated into routine dental implant care.
• While biofilm is key, managing foreign body responses is vital for long-term implant success.