Implications of considering peri-implant bone loss a disease, a narrative review

Tomas Albrektsson, Pentti Tengvall, Luis Amengual-Peñafiel, Pierluigi Coli, Georgios Kotsakis, David L. Cochran

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Background: Peri-implantitis has been suggested to cause significant increasing proportions of implant failure with increasing time. Purpose: To assess whether implant failure rates in long term studies are matching the supposed high prevalence of peri-implantitis. Material and Methods: This paper is written as a narrative review of the long-term clinical investigations available in the literature. Results: Some implant systems have seen unacceptable marginal bone loss figures with time coupled to increased implant failure rates, resulting in the withdrawal of these systems. The reasons for such mishap are generally unknown, with the exception of one system failure that was found to be due to improper clinical handling. Modern, moderately rough implant systems have functioned excellently over 10–15 years of follow up with minor problems with marginal bone loss and implant failure rates within a few per cent. Machined implants have functioned adequately over 20–30 years of follow up. Implant failures occur predominantly during the first few years after implant placement. No significant increase of implant failures has been observed thereafter over 20–30 years of follow up. Over the years of our new millennium, scientific and technical advances have allowed the discovery of numerous molecular pathways and cellular interactions between the skeletal and immune system promoting the development of the interdisciplinary field called osteoimmunology. Nowadays, this knowledge has not only allowed the emergence of new etiologic paradigms for bone disease but also a new dynamic approach on the concept of osseointegration and MBL around oral implants, re-evaluating our older disease oriented outlook. This facilitates at the same time the emergence of translational applications with immunological perspectives, scientific approaches based on omics sciences, and the beginning of an era of personalized dental implant therapy to improve the prognosis of oral implant treatment. Conclusions: Oral implant systems have been found to function with very good clinical outcome over follow-up times of 20–30 years. Registered implant failures have occurred predominantly during the first few years after implantation, and there has been no significant increase in late failures due to peri-implantitis.

Original languageEnglish (US)
Pages (from-to)532-543
Number of pages12
JournalClinical Implant Dentistry and Related Research
Volume24
Issue number4
DOIs
StatePublished - Aug 2022
Externally publishedYes

Keywords

  • bone resorption
  • dental implants
  • immuno-modulation
  • peri-implantitis

ASJC Scopus subject areas

  • Oral Surgery
  • Dentistry(all)

Fingerprint

Dive into the research topics of 'Implications of considering peri-implant bone loss a disease, a narrative review'. Together they form a unique fingerprint.

Cite this