Strategies for Optimizing the Soft Tissue Seal around Osseointegrated Implants

Abstract

Percutaneous and permucosal devices such as catheters, infusion pumps, orthopedic, and dental implants are commonly used in medical treatments. However, these useful devices breach the soft tissue barrier that protects the body from the outer environment, and thus increase bacterial infections resulting in morbidity and mortality. Such associated infections can be prevented if these devices are effectively integrated with the surrounding soft tissue, and thus creating a strong seal from the surrounding environment. However, so far, there are no percutaneous/permucosal medical devices able to prevent infection by achieving strong integration at the soft tissue-device interface. This review gives an insight into the current status of research into soft tissue-implant interface and the challenges associated with these interfaces. Biological soft/hard tissue interfaces may provide insights toward engineering better soft tissue interfaces around percutaneous devices. In this review, focus is put on the history and current findings as well as recent progress of the strategies aiming to develop a strong soft tissue seal around osseointegrated implants, such as orthopedic and dental implants.

Biological Responses to the Transitional Area of Dental Implants: Material- and Structure-Dependent Responses of Peri-Implant Tissue to Abutments

“…Hence, holes on the surface of the human body that contain implants are more vulnerable to containment failure. This mechanism of blockade by soft tissue is called a 'soft tissue seal' [30,33].…”

“…The stability and immobility of soft tissue attachments in contact with the implant abutment are important factors that affect the long-term prognosis of the implant [30,33]. If the soft tissues around the implant are deformed owing to the movement of the lip, cheek, tongue, or jaw, the weak soft tissue seal surrounding the implant may be destroyed.…”

Graphene Materials in Antimicrobial Nanomedicine: Current Status and Future Perspectives

“…[106,107] Therefore, as a prophylaxis against infections Adapted with permission. Often, there is lack of integration between the soft tissues and the device interfaces, resulting in inflammation, swelling, accumulation of bursal fluids, and eventually establishment of infection.…”

“…Such is the case for almost all biomaterials used in medical device fabrication. [106,107] Therefore, as a prophylaxis against infections Adapted with permission. [89] Copyright 2014, American Chemical Society.…”

Immunomodulation‐Based Strategy for Improving Soft Tissue and Metal Implant Integration and Its Implications in the Development of Metal Soft Tissue Materials

“…These include perforating metal implants artificial limbs, external fracture fixators, bone‐anchored hearing aids, and dental implants, which should be anchored in the hard tissue (bone) and extend through the soft tissue, either temporarily or permanently, to aid in recovery. [ 2 ] For these applications, favorable soft tissue integration means the development of a sufficient biological seal between the metal implants and the surrounding soft tissue, to create effective barriers between internal and external environments preventing bacterial invasion, tissue inflammation, loosening and failure of the implants. [ 3 ]…”