Clinical need and motivation

At the moment, peri-implantitis remains an unsolved issue not only within EU but also worldwide, affecting up to 43% of all dental implants. There are several factors that have been implicated in the development of peri-implantitis however, poor oral hygiene leading to the development of a pathogenic microbial biofilm or plaque is the most apparent concern in most of the patients. The pathogenesis begins when microorganisms (bacteria) accumulate on hard and soft surfaces in oral cavity. Bacteria will migrate from teeth to implants and from implant to implant and eventually microbial biofilms (plaque) will be formed. An over-aggressive immune response against these microorganisms leads to inflammation of the peri-implant soft tissues which eventually results in the progressive destruction of the alveolar bone. Although microbial biofilm accumulation is the main cause for the disease, various other local and systemic health factors have been identified as risk factors that increase the chances of peri-implantitis occurrence (e.g. patients with uncontrolled diabetes, heavy smokers and the immunosuppressed are more vulnerable to develop the disease).

Apart from systemic health related causes and oral hygiene habits, a critical factor for the development of peri-implantitis and the progression of the healing process is the geometry, structure and surface morphology of the implant itself. The main disadvantages of the currently available dental implants are:

  1. Have low regenerative potential and due to their structure and surface geometry can be vulnerable to bacterial biofilm formation.
  2. The acidic conditions in oral cavity can cause corrosion and eventually the release of debris and metal ions which eventually can lead to adverse tissue reactions and inflammation.
  3. Any impurity, residuals of the manufacturing process or even from the packaging, may be a trigger for unfavourable biological responses that lead to early marginal bone loss.