Current Concepts on the Pathogenesis of Peri-implantitis: A Narrative Review

Abstract

As implant treatment has been integrated in contemporary dental practice, complications with the forms of peri-implant mucositis and peri-implantitis have also increased in prevalence. Peri-implantitis is the more severe biological complication and is defined as an inflammatory disease affecting peri-implant tissues resulting in bone and eventually implant loss. In addition, the treatment of peri-implantitis has currently become a substantial global economic burden. In the current study, a search was conducted in several electronic databases using specific keywords relevant to the article’s main topic. An increasing number of scientific reports have investigated the etiopathology of peri-implant diseases, focusing mainly on peri-implantitis. Microbial biofilm consists an important etiological factor of peri-implant pathology analogous to periodontal diseases. Although several data confirm that peri-implant infections are dominated by gram-negative bacteria, similar to periodontal infections, there is evidence that some cases may harbor a distinct microbiota, including opportunistic microorganisms and/or uncultivable species. Additionally, data support that several parameters, such as genetic predisposition of individual patients, occlusal overload, and local factors such as titanium particles and excess cement, may be implicated in peri-implantitis pathogenesis. Simultaneously, the release of titanium metal particles and their biological consequences or the presence of excess cement in the adjacent peri-implant tissues have also been suggested as factors that contribute to peri-implant pathology. A specific line of research also indicates the role of foreign body response to implant installation. This narrative review aims to discuss the current concepts of etiopathogenetic factors implicated in peri-implantitis.

Similarity and Potential Relation Between Periimplantitis and Rheumatoid Arthritis on Transcriptomic Level: Results of a Bioinformatics Study

“…As the overlap between periimplantitis and RA was not addressed in those previous studies, a comparison is difficult. Generally, periimplantitis is a complex inflammatory disease, of which etiology and pathogenesis are still not fully understood ( 11 , 16 ). Primarily, a heterogenic biofilm of potentially pathogenic, opportunistic microorganisms appears to be essential for establishment of inflammation; however, genetic predisposition alongside with different immunological issues might be of high relevance in periimplantitis development and progression ( 16 ).…”

“…Generally, periimplantitis is a complex inflammatory disease, of which etiology and pathogenesis are still not fully understood ( 11 , 16 ). Primarily, a heterogenic biofilm of potentially pathogenic, opportunistic microorganisms appears to be essential for establishment of inflammation; however, genetic predisposition alongside with different immunological issues might be of high relevance in periimplantitis development and progression ( 16 ). Thereby, the microbiome of periimplantitis is complex; alongside with a heterogenic and various composition of microorganisms, prevalence of potentially periodontal pathogenic bacteria can be increased in inflamed periimplant tissues ( 26 ).…”

“…Periimplant inflammation shows several histopathological differences against periodontitis, including a higher aggressiveness and bone loss ( 13 ). Especially due to the high importance of immune system and the partially autoimmune character of periimplantitis as well as potential genetic predisposition for inflammation ( 14 – 16 ), the relationship between periimplant inflammation and RA appears somewhat reasonable and of clinical interest. Available literature did not confirm an association between periimplantitis and RA ( 17 , 18 ), yet.…”

Graphene for Antimicrobial and Coating Application

“…It is challenging to produce implants with a high degree of osseointegration at the same time as inhibiting bacterial colonization [ 125 , 126 , 127 ]. The peri-implant diseases around implant result in implants failure due to supporting bone loss around the implant [ 128 , 129 , 130 , 131 , 132 ].…”

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“…Periimplant inflammation shows several histopathological differences against periodontitis, including a higher aggressiveness and bone loss (13). Especially due to the high importance of immune system and the partially autoimmune character of periimplantitis as well as potential genetic predisposition for inflammation (14)(15)(16), the relationship between periimplant inflammation and RA appears somewhat reasonable and of clinical interest. Available literature did not confirm an association between periimplantitis and RA (17,18), yet.…”