From Periodontitis to Periimplantitis —the Quest for the Missing Link

AbstractPurpose of ReviewIn 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 FindingsThe 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.SummaryThe search to improve our treatment strategies in periimplantitis should first focus on establishing o...
Source: Current Oral Health Reports - Category: Dentistry Source Type: research