Peri-Implantitis Research Paper

Since the mid-1960s, dental implants have been successfully used to treat edentulous patients, with a survival rate higher than 90% after 15 years.1 In the last decades, several physical and chemical treatments of the titanium surface improved its biocompatibility, in terms of both biosafety and biofunctionality. The good clinical performance of an implant depends on osseointegration, i.e. the formation of an effective interface between implant and bone, and gingival attachment, which occurs through junctional epithelium (JE).2 Several studies have primarily focused on bone response, leading to the development of surface optimization strategies to allow a rapid osseointergration and to improve the strength and stability of bone-implant interaction.3 Nowadays, it is widely accepted that rough surfaces, rather than smooth ones, favor a greater osteoblast anchorage, thus facilitating the prosthesis osseointegration.4 However, as peri-implantitis represents …show more content…
Peri-implantitis is an increasingly accelerating disease and its progression, once lost the equilibrium between mucosal seal and bacterial challenge, occurs with little resistance from the host tissues.6 While in periodontal disease the lesion never reaches the bone tissue, in peri-implantitis it does invade the bone up to marrow spaces, suggesting a weakness of the immune defense mechanism.7 The pathogenesis of both periodontal and peri-implant disease clearly demonstrates that the first event characterizing attachment loss following bacterial accumulation is epithelial downgrowth, which displaces the underlying connective tissue.8,9 While connective attachment to the implant surface is crucial especially for the initial mucosal seal establishment, during the pathological situation epithelial downgrowth will occur no matter the type and strength of this first