Peri-Implantitis: A New Definition Proposal Based on Unnatural Spatial Arrangement and Late Mechanical Coupling between Two Cortical Bone Layers during Osseointegration Phase Part II

Abstract

To date, the term peri-implantitis has been mostly associated with bacterial or foreign body reaction as primary factors of its development. Because of this, researchers’ and clinicians’ attention regarding treatment possibilities were directed into the solutions on the basis of surface modifications, debridement, and antibiotics. After years of clinical observations and poor results in treatment of peri-implantitis, a new proposal of this condition is presented, shifting our way of thinking regarding bone and implant interactions. In the second part of the paper presenting a new definition of peri-implantitis, we focused on a biological explanation of the bone behavior at the bone–implant interface. The main conclusion is that PI is not an “infectious disease”, but rather the result of natural changes of the bone’s morphology in response to implant such as a decrease in convexity of the outer surface of the bone and subsequently a decrease in concavity of the inner bone.

Short Implants versus Longer Implants with Sinus Floor Elevation: A Systemic Review and Meta-Analysis of Randomized Controlled Trials with a Post-Loading Follow-Up Duration of 5 Years

“…Stefan et al inferred that the marginal bone loss was a result of natural changes in the bone's morphology in response to the implant, such as a decrease in the convexity of the outer surface and concavity of the inner bone [53]. They found that when implants showed a vertical bone loss, apical bone part rather increased.…”

Oral rehabilitation with dental implants in patients with systemic sclerosis: A systematic review

“…Peri‐implantitis and periodontitis refer to the progressive inflammation of the supporting structure of implants and teeth. An imbalance between the internal immunological response of the host and the foreign body response causes these conditions, 16 which in turn leads to implant surface contamination, alveolar bone loss, tooth/implant loss, and tooth mobility 17 . The distinctive clinical profile in patients with periodontal inflammation and SSc includes widened periodontal ligament, 18 decreased bleeding index and probing depth, and increased periodontal attachment loss 2 .…”