Implantoplasty releases metal particles that may induce pro-inflammatory response

Peri-implantitis is defined as a pathological condition caused by bacterial biofilms and characterized by inflammatory changes in the peri-implant mucosa, with progressive bone loss around an osseointegrated dental implant. This biological complication can jeopardize implant-prosthetic restoration if left untreated. The treatment of peri-implant diseases includes the decontamination of the implant surface by means of mechanical, chemical or electrolytic techniques. It must be pointed out that the literature does not clearly indicate the superiority of one specific decontamination protocol over the others. In fact, most of these decontamination techniques are not able to completely remove the biofilm from the dental implant surface, probably due to the macro and micro-design of the implant and the defect configuration. Clinical studies have suggested that the resolution of the peri-implant disease may be influenced by other factors than the method of surface decontamination

Implantoplasty is a mechanical decontamination technique that consists of removing the threads and polishing and smoothing the dental implant surface. During implantoplasty there is a large release of titanium metal particles that might provoke a proinflammatory response and reduce the viability of osteogenic cells. We analyze the inflammatory and osteogenic response induced by Ti6Al4V particles released during implantoplasty and by as-received commercially pure Ti particles. Macrophages stimulated with metal particles obtained by implantoplasty and with as-received Ti particles showed an increased proinflammatory expression of TNF-α and a decreased expression of TGF-β and CD206. Regarding cytokine release, there was an increase in IL-1β, while IL-10 decreased. The osteogenic response of Ti6Al4V extracts showed a significant decrease in Runx2 and OC expression compared to the controls and commercially pure Ti extracts. There were no relevant changes in ALP activity.

Thus, implantoplasty releases metal particles that seemseem to induce a pro-inflammatory response and reduce the expression of osteogenic markers.

Reference:

Toledano-Serrabona, J., Bosch, B.M., Díez-Tercero, L. et al. Evaluation of the inflammatory and osteogenic response induced by titanium particles released during implantoplasty of dental implants. Sci Rep 12, 15790 (2022). https://doi.org/10.1038/s41598-022-20100-2