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From Periodontitis to Periimplantitis—the Quest for the Missing Link

  • Host Parasite Interactions in Periodontal Disease (C Genco and D Kinane, Section Editors)
  • Published:
Current Oral Health Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

In this narrated review, we shall study the commonality and discord in the anatomy, bacterial flora, immune response, rate of progression, and response to therapy. Finally, we shall explore the unique, periimplantitis-related risk factors.

Recent Findings

The absence of PDL around implants, combined with poor periimplant vascularization and weaker attachment apparatus, might account for the poor cellular response to bacterial implant in periimplantitis. Using 16S ribosomal gene sequencing, it has been recently shown that although certain known periodontal pathogens may also be found around dental implants with periimplantitis, apparently, the multiplicity of bacterial flora in this condition is great with some distinct microorganisms associated with periimplantitis. The inflammatory cell infiltrate is more pronounced than in periodontitis and extended more apically. Mean bone loss in periimplantitis is generally much greater than around natural teeth with periodontitis. Risk factors that are uniquely associated with dental implants include bone type, prosthetic and surgical variables, and implant surface characteristics. The role of titanium particles found in the periimplantitis lesion is yet unclear. Lastly, the possibility of foreign body reaction being the trigger for periimplantitis is plausible but as of yet requires further substantiation.

Summary

The search to improve our treatment strategies in periimplantitis should first focus on establishing or declining the primary mode of breakdown. The results of such studies will help guide us to either improve our current anti-infective therapies targeting the unique characteristics of periimplantitis or else put us on a new road to understanding how to modify or restrict the natural immunological response as might be the case for a foreign body response.

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Authors and Affiliations

  1. Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus and Faculty of Medicine, the Technion, I.I.T., 8 Haalia-hashnia St., P.O. Box 9602, 31096, Haifa, Israel

    Eli E. Machtei

  2. Division of Periodontology, Department of Oral Medicine, Infection and Immunity, School of Dental Medicine, Harvard University, Boston, MA, USA

    Eli E. Machtei

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Correspondence to Eli E. Machtei.

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Machtei, E.E. From Periodontitis to Periimplantitis—the Quest for the Missing Link. Curr Oral Health Rep 7, 72–78 (2020). https://doi.org/10.1007/s40496-020-00252-8

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