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Oral Medicine Periodontics Restorative Dentistry

What are the microbiological and immuno-pathological aspects of peri-implant diseases?


This summary is based on the article published in the Archives of Oral Biology: Microbiological and immuno-pathological aspects of peri-implant diseases (January 2014)


Peri-implant diseases are a cluster of ‘‘contemporary’’ oral infections in humans that have emerged as a result of the routine application of osseointegrated dental implants in clinical practice. They are characterized by the inflammatory destruction of the implant-supporting tissues, as a result of biofilm formation on the implant surface. Peri-implant mucositis and peri-implantitis are analogous to gingivitis and periodontitis that affect natural teeth. 

The Purpose of the Review

Provide insights into the infectious aetiology and immuno-pathology of peri-implant diseases, and to identify similarities and differences with periodontal diseases. 

Key Messages

  • The microbial composition of peri-implantitis-associated biofilms is mixed, non-specific and very similar to that of periodontitis.
  • A considerable exception is the frequent presence of high numbers of staphylococci and enteric bacteria in peri-implantitis.
  • The sequence of immuno-pathological events and the qualitative composition of the immune cells in peri-implant infections are similar to that of periodontal infections.
  • The lesions are characterized predominantly by neutrophils, macrophages, T and B-cells.
  • Nevertheless, compared to periodontitis, peri-implantitis is marked by a more extensive inflammatory infiltrate and innate immune response, a greater severity of tissue destruction and a faster progression rate.
  • This could well account for the structural differences between the two tissue types, predominantly the lack of periodontal ligament and Sharpey’s fibres around implants.
  • In order to support the early diagnosis and prevention of peri-implantitis, it is crucial to explain its fast progression rate by elucidating the underlying molecular mechanisms. This could be achieved, for instance, by utilizing the non-invasive collection and analysis of peri-implant crevicular fluid.


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