Bone biology in aging periodontal and peri-implant tissues

Periodontal disease is an age-related chronic inflammatory condition leading to tooth loss. Dental implants are an option for replacement of lost teeth in older adults. However, age-related changes to alveolar bone may have pathological implications for its role in supporting the dentition and dental implants.

This narrative review will focus on the age-related changes that affect alveolar bone and the implications for periodontal disease and implant dentistry.

A literature search using the PubMed database was conducted. Search terms focused on the known age-related pathological process affecting bone and involved in peri-implant and periodontal disease.

The literature demonstrates the multi-faceted physiological changes that affect alveolar bone as a function of increased age. Osteoporosis is a commonly recognized feature of aging and studies support its association with periodontal disease as well as the growing body of work demonstrating the effects of osteoporosis on dental implant success. Furthermore, age-related cellular perturbations have a detrimental impact on the strict inflammatory regulation that is required for bone homeostasis and during healing and regenerative processes. Finally, age-related changes to osteoprogenitor cells likely contribute to pathology in the alveolar bone. However, multiple therapeutic targets have been identified to alter osteoprogenitor cell function for improvement of bone regeneration and homeostasis.

Pathological changes that occur with age can be detrimental to alveolar bone, and an improved understanding of such changes can translate to future treatment modalities for the enhanced management of periodontal disease and dental implants in older adults.