Peri‐implantitis and its prevention

Berglundh, Tord; Jepsen, Søren; Stadlinger, Bernd; Terheyden, Hendrik

doi:10.1111/clr.13401

Cited by 117 publications

(107 citation statements)

References 52 publications

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“…Biological and technical complications can occur around osseointegrated dental implants leading to peri‐implant diseases (Berglundh, Jepsen, Stadlinger, & Terheyden, ; Derks & Tomasi, ). Although the disease progression is a relatively well‐known process, the etiology of peri‐implantitis remains elusive.…”

Section: Introductionmentioning

confidence: 99%

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Characterization of macrophages infiltrating peri‐implantitis lesions

Fretwurst

Garaicoa-Pazmiño

Nelson

et al. 2020

Clinical Oral Implants Res

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Objectives The mechanisms involved in the initiation and progression of peri‐implantitis lesions are poorly understood. It was the aim to determine the content and activation status of macrophages present in human peri‐implantitis lesions and compare the current findings with the macrophage polarization associated with periodontitis lesions. Material and Methods A total of 14 patients were studied in this investigation. Seven were soft tissue biopsies from dental implants affected by peri‐implantitis that required explantation. Seven biopsies were from chronic periodontal disease. Immunofluorescence stains were performed using biomarkers to identify macrophages (CD68+) undergoing M1 polarization (iNOS+) and M2 polarization (CD206+), along with Hoechst 33,342 to identify DNA content. All samples were stained and photographed, and double‐positive cells for CD68 and iNOS or CD68 and CD206 were quantified. Results All peri‐implantitis biopsies examined revealed a mixed population of macrophages undergoing M1 polarization and M2 polarization. Further analysis demonstrated the co‐expression of iNOS and CD206, which indicates the presence of a heterogenic immune response on peri‐implantitis lesions. Macrophage polarization in peri‐implantitis lesions presents a distinct pattern than in periodontitis. We observed a significant increase in the population of M1 macrophages on peri‐implantitis samples compared to periodontal disease samples. Conclusion Our results demonstrate that peri‐implantitis has higher numbers of macrophages displaying a distinct macrophage M1 polarization signature compared to periodontitis lesions. This pattern may explain, in part, the distinct nature of peri‐implantitis progression vs. periodontitis in humans.

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Section: Introductionmentioning

confidence: 99%

“…Biological and technical complications can occur around osseointegrated dental implants leading to peri-implant diseases (Berglundh, Jepsen, Stadlinger, & Terheyden, 2019;Derks & Tomasi, 2015).…”

Section: Introductionmentioning

confidence: 99%

Characterization of macrophages infiltrating peri‐implantitis lesions

Fretwurst

Garaicoa-Pazmiño

Nelson

et al. 2020

Clinical Oral Implants Res

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“…Epithelial attachment to the abutment surface is required to form a tight barrier to protect the underlying bone from microorganisms and other pathogenic insults. Pathogenic microbial colonisation can lead to periwww.ecmjournal.org S Gibbs et al Epithelium attachment to abutment surface implantitis, characterised by gingival recession, inflammation and bone resorption, often culminating in dental implant failure [see extensive reviews of clinical studies (Berglundh et al, 2019;Hammerle et al, 2012;Lang and Lindhe, 2015;Sculean et al, 2014)]. A balance is maintained thanks to the barrier function of the epithelium and the microbiome, which is aided by the multitude of wound healing and antimicrobial molecules in the saliva (Brand et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Biology of soft tissue repair: gingival epithelium in wound healing and attachment to the tooth and abutment surface

Gibbs

Roffel²,

Meyer³

et al. 2019

eCM

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Epithelium attachment to the tooth or abutment surface is necessary to form a biological seal preventing pathogens and irritants from penetrating the body and reaching the underlying soft tissues and bone, which in turn can lead to inflammation and subsequent bone resorption. The present review investigated oral wound closure and the role of micro-environment, saliva, crevicular fluid and microbiota in wound healing. The importance of the junctional epithelium (peri-implant epithelium) attachment to the abutment surface was investigated. Current research focuses on macro-design, surface-topography, surface-chemistry, materials, coatings and wettability to enhance attachment, since these optimised surface properties are expected to promote keratinocyte attachment and spreading through hemi-desmosome formation. Detailed studies describing the extent of junctional epithelium attachment-e.g. barrier function, hemi-desmosomes, epithelium quality, composition of the external basement membrane or ability of the epithelium to resist microbial penetration and colonisation-are not yet reported in animals due to ethical considerations, scalability, expense, technical challenges and limited availability of antibodies. In vitro studies generally include relatively simple 2D culture models, which lack the complexity required to draw relevant conclusions. Additionally, human organotypic 3D mucosa models are being developed. The present review concluded that more research using these organotypic mucosa models may identify relevant parameters involved in soft-tissueabutment interactions, which could be used to study different macro-shapes and surface modifications. Such studies would bridge the gap between clinical, animal and traditional in vitro cell culture studies supporting development of abutments aiming at improved clinical performance.

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“…Clinical trials directed to this specific condition has proven extremely challenging for researchers, as dental implants are a high-cost medical option in many countries, and peri-implantitis may be classified as an asymptomatic iatrogenic disease [40]. In the meantime, the clear lack of well-defined protocols and gold-standard approaches to tackle peri-implantitis reiterate the importance of meticulous preventative strategies in an attempt to arrest or delay the onset of the disease [56].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of peri-implantitis treated with bone substitute and resorbable membrane: a literature review with a systematic approach

Alves¹,

Duarte

Martinez

et al. 2019

RGO, Rev. Gaúch. Odontol.

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Objective: The objective of this review was to evaluate the outcomes of the treatment of peri-implant defects, using Guided Bone Regeneration. Methods: A literature search was performed based on the PICO methodology in the PubMed/Medline, SciELO, Lilacs electronic databases, CAPES periodicals and the Cochrane Library. We included studies using bovine mineral matrix, associated to a collagen membrane for the treatment of peri-implantitis by Guided Bone Regeneration. Results: Of 1,163 studies, 10 were included in this review after applying the evaluation criteria. A total of 269 implants were treated in 260 patients. The follow-up period ranged from 6 to 48 months. The studies evaluated outcome in terms of reduction in probing depth, gain of clinical attachment and healing of the bony defect. Due to the heterogeneity of the studies, it was not possible to perform meta-analysis. Conclusion: Treatment of peri-implant lesions with Guided Bone Regeneration is a viable modality of treatment, providing reduction in bleeding on probing, as well as gain of clinical attachment. Complete filling of the defect is, however, an unpredictable result.

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Peri‐implantitis and its prevention

Cited by 117 publications

References 52 publications

Characterization of macrophages infiltrating peri‐implantitis lesions

Characterization of macrophages infiltrating peri‐implantitis lesions

Biology of soft tissue repair: gingival epithelium in wound healing and attachment to the tooth and abutment surface

Clinical outcomes of peri-implantitis treated with bone substitute and resorbable membrane: a literature review with a systematic approach

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