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Peri-implantitis with a potential axis to brain inflammation: an inferential review

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Abstract

Peri-implantitis (PI) is a chronic, inflammatory, and infectious disease which affects dental implants and has certain similarities to periodontitis (PD). Evidence has shown that PD may be related to several types of systemic disorders, such as diabetes and insulin resistance, cardiovascular diseases, respiratory tract infections, adverse pregnancy outcomes, and neurological disorders. Furthermore, some types of bacteria in PD can also be found in PI, leading to certain similarities in the immunoinflammatory responses in the host. This review aims to discuss the possible connection between PI and neuroinflammation, using information based on studies about periodontal disorders, a topic whose connection with systemic alterations has been gaining the interest of the scientific community. Literature concerning PI, PD, and systemic disorders, such as neuroinflammation, brain inflammation, and neurological disorder, was searched in the PubMed database using different keyword combinations. All studies found were included in this narrative review. No filters were used. Eligible studies were analyzed and reviewed carefully. This study found similarities between PI and PD development, maintenance, and in the bacterial agents located around the teeth (periodontitis) or dental implants (peri-implantitis). Through the cardiovascular system, these pathologies may also affect blood-brain barrier permeability. Furthermore, scientific evidence has suggested that microorganisms from PI (as in PD) can be recognized by trigeminal fiber endings and start inflammatory responses into the trigeminal ganglion. In addition, bacteria can traverse from the mouth to the brain through the lymphatic system. Consequently, the immune system increases inflammatory mediators in the brain, affecting the homeostasis of the nervous tissue and vice-versa. Based on the interrelation of microbiological, inflammatory, and immunological findings between PD and PI, it is possible to infer that immunoinflammatory changes observed in PD can imply systemic changes in PI. This, as discussed, could lead to the development or intensification of neuroinflammatory changes, contributing to neurodegenerative diseases.

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Fig. 1

(Imagens adapted from BioRender: Scientific Image and Illustration Software, 2023)

Fig. 2
Fig. 3

(The images were adapted from Sansores-España et al. [13], and BioRender: Scientific Image and Illustration Software, 2023)

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Abbreviations

PI:

Peri-implantiti

PT:

Periodontitis

PD:

Periodontal disease

TRP:

Toll-Like Receptors

IL-1β:

Interleukin-1β

IL-6:

Interleukin-6

IL-17:

Interleukin-17

TNF-α:

Tumor necrosis factor alpha

BBB:

Blood–brain barrier

MMP-2:

Matrix metalloproteinases 2

MMP-9:

Matrix metalloproteinases 9

rRNA:

Ribosomal ribonucleic acid

TRL4:

Toll-like receptor 4

TRP:

Transient Receptor Potential

NF-κB:

Factor nuclear kappa B

ROS:

Reactive oxygen species

Ca:

Calcium

TLRs:

Toll-like receptors

LPS:

Lipopolysaccharide

TRPV1:

Transient receptor potential cation channel V1

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Acknowledgements

We thank the North University Center of São Paulo, University Center of Santa Fé do Sul, São Paulo State University and Union of Colleges of the Great Lakes for all support to carry out this study.

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Authors and Affiliations

  1. University Center in the North of São Paulo (UNORTE), São José Do Rio Preto, SP, 15020-040, Brazil

    Gestter Willian Lattari Tessarin & Renato Gomes Azevedo

  2. Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil

    Gestter Willian Lattari Tessarin, Luan Felipe Toro & Rodrigo Martins dos Santos

  3. Marilia Medical School (FAMEMA), Marília, São Paulo, Brazil

    Luan Felipe Toro

  4. Union of Colleges of the Great Lakes (UNILAGO), São José Do Rio Preto, São Paulo, Brazil

    Renato Felipe Pereira

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GWLT: conception, design, supervision, data analyses and interpretation, drafted, figures and final version of this manuscript. LFT: design, data analyses and interpretation, draft, and critical revision; RFP: data analyses and interpretation, drafted, and critical revision; RMdS: interpretation, draft, and critical revision. RGdA: interpretation, draft, and critical revision.

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Tessarin, G.W.L., Toro, L.F., Pereira, R.F. et al. Peri-implantitis with a potential axis to brain inflammation: an inferential review. Odontology (2024). https://doi.org/10.1007/s10266-024-00936-y

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