Biomarker-Guided Implant Maintenance (BGIM): A Narrative Review and Protocol Proposal

Area of Science:

• Dental Medicine
• Biomaterials Science
• Periodontology

Background:

• Dental implants are a predictable treatment for missing teeth, but complications like peri-implant disease can occur.
• Peri-implant disease involves bone loss and inflammation, negatively impacting patient quality of life.
• Understanding the etiology, epidemiology, and pathogenesis of peri-implant disease is crucial for effective management.

Purpose of the Study:

• To review current knowledge on peri-implant disease, focusing on its causes, prevalence, and risk factors.
• To evaluate the diagnostic potential of active matrix metalloproteinase-8 (aMMP-8) in peri-implant sulcular fluid.
• To propose a novel protocol for individualized implant maintenance scheduling.

Main Methods:

• A literature search was conducted in PubMed and Scopus databases for studies on peri-implantitis and biomarkers.
• Included were clinical studies, systematic reviews, meta-analyses, and consensus papers published up to June 2025.
• A new protocol, Biomarker-Guided Implant Maintenance (BGIM), was developed based on key risk factors and aMMP-8 levels.

Main Results:

• Active matrix metalloproteinase-8 (aMMP-8) shows diagnostic potential for assessing peri-implant tissue status.
• The BGIM protocol categorizes patients into risk levels for peri-implantitis.
• Higher risk levels correlate with a need for more frequent professional maintenance.

Conclusions:

• The BGIM protocol offers a structured, clinically applicable framework for personalized implant maintenance.
• Integrating aMMP-8 quantification with patient risk factors can optimize implant care.
• Prospective validation is required, but the BGIM protocol may enhance implant longevity by preventing peri-implant disease.