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.
- 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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