Peri-implantitis:a biomaterial-associated complication in dental implants
LI Dehua
LIU Yi
WANG Fei
Abstract：Dental implant technology is the first choice for the restoration of missing teeth,but the high incidence of peri-implantitis(reaching 57％among patients)and treatment resistance seriously threaten the long-term survival of implants.The traditional view holds that it is similar to periodontitis and is an infectious disease caused by plaque microorganisms.However,systematic comparison reveals that there are essential differences between them.①Anatomically,peri-implant tissues lack a periodontal ligament,exhibiting weaker mucosal attachment and vulnerable physical barrier function to infection.②Histopathologically,lesions show more extensive inflammation with higher densities of plasma cells,macrophages,and neutrophils,alongside frequent titanium particle release triggering macrophage activation.③Immunologically,dysregulated innate immunity predominates(e.g.,hyperactivated Toll-like receptor/TNF signaling pathway),with enhanced neutrophil recruitment,M1 macrophage polarization,and heightened Th17/B-cell responses.④Microbiologically,while sharing periodontal pathogens(e.g.,red complex),peri-implantitis harbors unique bacteria(e.g.,Staphylococci,enteric bacteria species)and exhibits complex ecological shifts,potentially exacerbated by titanium particles.Thus,peri-implantitis arises from tripartite interactions among microbiota,biomaterials(titanium particles),and dysregulated host immunity(notably innate immunity/foreign body reactions),providing a mechanistic foundation for precision management.
Keywords：peri-implantitisperiodontitishistopathologyimmunologyinnate immunitybiofilmsprosthesis failurealveolar bone loss
Publication Date：2025-10-31
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：7( 1261-1267 )