Tomas Albrektsson1,2, William Becker3,4, Pierluigi Coli5, Torsten Jemt6, Johan Mölne7, Lars Sennerby8. 1. Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden. 2. Department of Prosthodontics, University of Malmö, Malmö, Sweden. 3. Department of Periodontics, University of Southern California School of Dentistry, Los Angeles, California. 4. Department of Periodontics, University of Washington School of Dentistry, Seattle, Washington. 5. Private Clinic, Edinburgh, Scotland. 6. Department of Prosthodontics, University of Gothenburg, Gothenburg, Sweden. 7. Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 8. Department of Oral & Maxillofacial Surgery, University of Gothenburg, Gothenburg, Sweden.
Abstract
BACKGROUND: Marginal bone resorption has by some been identified as a "disease" whereas in reality it generally represents a condition. PURPOSE: The present article is a comparison between oral and orthopedic implants, as previously preferred comparisons between oral implants and teeth seem meaningless. MATERIALS AND METHODS: The article is a narrative review on reasons for marginal bone loss. RESULTS AND CONCLUSIONS: The pathology of an oral implant is as little related to a tooth as is pathology of a hip arthroplasty to a normally functioning, pristine hip joint. Oral as well as orthopedic implants are recognized as foreign bodies by the immune system and bone is formed, either in contact or distance osteogenesis, to shield off the foreign materials from remaining tissues. A mild immune reaction coupled to a chronic state of inflammation around the implant serve to protect implants from bacterial attacks. Having said this, an overreaction of the immune system may lead to clinical problems. Marginal bone loss around oral and orthopedic implants is generally not dependent on disease, but represents an immunologically driven rejection mechanism that, if continuous, will threaten implant survival. The immune system may be activated by various combined patient and clinical factors or, if rarely, by microbes. However, the great majority of cases with marginal bone loss represents a temporary immune overreaction only and will not lead to implant failure due to various defense mechanisms.
BACKGROUND: Marginal bone resorption has by some been identified as a "disease" whereas in reality it generally represents a condition. PURPOSE: The present article is a comparison between oral and orthopedic implants, as previously preferred comparisons between oral implants and teeth seem meaningless. MATERIALS AND METHODS: The article is a narrative review on reasons for marginal bone loss. RESULTS AND CONCLUSIONS: The pathology of an oral implant is as little related to a tooth as is pathology of a hip arthroplasty to a normally functioning, pristine hip joint. Oral as well as orthopedic implants are recognized as foreign bodies by the immune system and bone is formed, either in contact or distance osteogenesis, to shield off the foreign materials from remaining tissues. A mild immune reaction coupled to a chronic state of inflammation around the implant serve to protect implants from bacterial attacks. Having said this, an overreaction of the immune system may lead to clinical problems. Marginal bone loss around oral and orthopedic implants is generally not dependent on disease, but represents an immunologically driven rejection mechanism that, if continuous, will threaten implant survival. The immune system may be activated by various combined patient and clinical factors or, if rarely, by microbes. However, the great majority of cases with marginal bone loss represents a temporary immune overreaction only and will not lead to implant failure due to various defense mechanisms.
Authors: Nicholas G Fischer; Alexandra C Kobe; Jinhong Dai; Jiahe He; Hongning Wang; John A Pizarek; David A De Jong; Zhou Ye; Shengbin Huang; Conrado Aparicio Journal: Acta Biomater Date: 2021-12-29 Impact factor: 8.947
Authors: David Reinedahl; Silvia Galli; Tomas Albrektsson; Pentti Tengvall; Carina B Johansson; Petra Hammarström Johansson; Ann Wennerberg Journal: J Clin Med Date: 2019-08-18 Impact factor: 4.241
Authors: Sabine Schluessel; Eliza S Hartmann; Miriam I Koehler; Felicitas Beck; Julia I Redeker; Maximilian M Saller; Elif Akova; Stefan Krebs; Boris M Holzapfel; Susanne Mayer-Wagner Journal: Front Immunol Date: 2022-02-11 Impact factor: 7.561