Etiology and prevention of peri-implantitis

Abstract

Dental implants are one of the effective ways to replace missing teeth. Although favorable long-term results of implant therapy have been reported, the incidence of biological complications occurred around periimplant tissues has also increased. Peri-implantitis and peri-implant mucositis are thought to be caused by dysbiosis in bacterial biofilm, and inflammatory tissue destruction around the implant progresses due to the disruption of homeostasis. For a long time, many researchers have considered that bacterial pathogens related to peri-implant diseases are similar with those of periodontitis. Recently, we tried the comprehensive analysis of microbiota using next-generation sequencing technique and found the difference of interacting core taxa between peri-implantitis and periodontitis. Besides, there were several species frequently found at the sites with peri-implantitis, suggesting that they would play important roles in the dysbiotic biofilm related to peri-implantitis. Systemic conditions such as smoking habit and/or presence of diabetes mellitus are possibly associated with the development of peri-implantitis, while it is inconclusive as established risk indicators. In the consensus report from the 2017 World Workshop held by the American Academy of Periodontology and European Federation of Periodontology, a history of severe periodontitis, poor plaque control, and no regular maintenance care after implant therapy were listed as the rational risk indicators of peri-implantitis. The treatment of peri-implantitis is mainly focused on infection controls. Although the treatment of peri-implantitis is generally carried out according to the treatment for periodontitis, its predictability is not high. Both surgical and non-surgical techniques have been proposed, however, there is still no specific recommendation for the treatment for peri-implantitis. At present, therefore, it would be important to prevent and find the diseases at an early stage by follow-up care