Biomaterial‐based possibilities for managing peri‐implantitis

Abstract

Peri‐implantitis is an inflammatory disease of hard and soft tissues around osseointegrated implants, followed by a progressive damage of alveolar bone. Oral microorganisms can adhere to all types of surfaces by the production of multiple adhesive factors. Inherent properties of materials will influence not only the number of microorganisms, but also their profile and adhesion force onto the material surface. In this perspective, strategies to reduce the adhesion of pathogenic microorganisms on dental implants and their components should be investigated in modern rehabilitation concepts in implant dentistry. To date, several metallic nanoparticle films have been developed to reduce the growth of pathogenic bacteria. However, the main drawback in these approaches is the potential toxicity and accumulative effect of the metals over time. In view of biological issues and in attempt to prevent and/or treat peri‐implantitis, biomaterials as carriers of antimicrobial substances have attracted special attention for application as coatings on dental implant devices. This review will focus on biomaterial‐based possibilities to prevent and/or treat peri‐implantitis by describing concepts and dental implant components suitable for engagement in preventing and treating this disease. Additionally, we raise important criteria referring to the geometric parameters of dental implants and their components, which can directly affect peri‐implant tissue conditions. Finally, we overview currently available biomaterial systems that can be used in the field of oral implantology.

Enhanced Human Gingival Fibroblast Response and Reduced Porphyromonas gingivalis Adhesion with Titania Nanotubes

“…The early failure of dental implants mostly results from bacteria and plaque formation on the implant surfaces before soft-tissue integration occurs, especially in the cases of periodontal disease [42]. Given the difficulty of killing bacteria after binding to the implant surface, prevention strategies have therefore become extremely important [43].…”

Counter-Acting Candida albicans-Staphylococcus aureus Mixed Biofilm on Titanium Implants Using Microbial Biosurfactants

“…In recent years, different surfaces or coatings with antibacterial or anti-biofilm properties have been proposed to protect implants [ 37 , 38 , 39 ]. However, several limitations in safely and effectively implementing these strategies in clinical settings were reported [ 40 ]. Considering the multivariate causes of peri-implant disease, the right solution to prevent peri-implant diseases should identify strategies able to eliminate or minimize initial bacterial attachment without having a cytotoxic effect to allow and favor stable osseointegration and strengthen the peri-implant mucous seal [ 41 ].…”

Effect of sodium ascorbyl phosphate on osteoblast viability and differentiation

“…In view of the findings presented herein, there could be a potential role for SAP incorporated into controlled release devices or scaffolds/membranes, as reported in the medical literature with the use of poly‐lactic acid frameworks for pelvic floor reconstruction 44 . Such controlled release devices could be used in periodontal pockets after conservative scaling and root planing to enhance periodontal healing 45,46 or to prevent or treat peri‐implantitis, 47 whereas membranes or scaffolds loaded with SAP could be used to optimize guided tissue or bone regeneration 48‐50 . The use of SAP instead of AA in its pure form may confer protection against the challenging environment seen in the periodontium.…”