Dental implant rehabilitation has become widely used due to its highly predictable functional and esthetic results compared to conventional crown/bridge work and dentures. In addition, implant materials made of titanium offers not only biocompatibility but also osseointegration. Osseointegration refers to the direct connection between live bone and the surface of the implant during function and loading in the oral cavity. Despite the high rate success of dental implants, there is a small percentage of its failure which can partly be attributed to peri-implantitis. It refers to the variations in pathological inflammation that occurs in the tissue surrounding a load bearing dental implant. What also presents a challenge in orofacial implantology is that the dental implant surface is prone to microbial colonization and formation of a biofilm which may eventually lead to infection of the implant-supported tissue [1,2,4,10].
The classification of failure the dental implant function can be divided into two stages: early or late. Early stage of implant failures occur due to incomplete osseointegration prior to or following the functional loading of the implant. Failures include: early loading, surgical contamination, inefficient healing, and undesirable biocompatibility of implant material. Late failure of dental implants includes disruption of the function of existence osseointegrated implants, mainly because of the chronic infection of implant tissue .
There are risk factors for peri-implantitis such as poor oral hygiene, systemic conditions, alcohol consumption, susceptibility of genes, smoking and a previous history of periodontitis. Clinically, it is quite possible to distinguish between peri-implant mucositis, wh...
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...he bone marrow is what distinguishes peri-implantitis .
The formation of biofilm on implant surface is similar to that on natural teeth leading to inflammation and subsequent damage of the surrounding tissue. The neighbouring teeth, periodontal pocket, saliva and soft oral tissue act as reservoirs for contamination of the implant surface. There is also a similarity in microbiological characteristics in peri-implantitis and periodontitis but there are some exceptions including some specific microbiota such as staphylococci, peptostreptococci, enterobacteria and candida spp. that are seen in peri implantitis. In addition, the immune response of the cells are quite similar in peri-implantitis in both events and qualitatively. On the other hand, the inflammatory tissue destruction in peri-implantitis is faster and more extensive than in periodontitis.
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