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Albrektsson, Tomas
Publications (10 of 93) Show all publications
Reinedahl, D., Johansson, P., Galli, S., Kjellin, P., Albrektsson, T. & Wennerberg, A. (2022). Review of PEEK implants and biomechanical and immunological responses to a zirconium phosphate nano-coated PEEK, a blasted PEEK, and a turned titanium implant surface.. American Journal of Dentistry, 35(2), 152-160
Open this publication in new window or tab >>Review of PEEK implants and biomechanical and immunological responses to a zirconium phosphate nano-coated PEEK, a blasted PEEK, and a turned titanium implant surface.
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2022 (English)In: American Journal of Dentistry, ISSN 0894-8275, Vol. 35, no 2, p. 152-160Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To investigate the biomechanical and immunological reactions to coated and non-coated blasted PEEK implants in vivo after 12 weeks and review the associated literature.

METHODS: Two osteotomy sites were performed in each proximal tibia of 10 lop-eared rabbits (n= 4 per rabbit). Each rabbit received a randomly placed (1) blasted zirconium phosphate nano-coated PEEK- (nano-ZrP), (2) blasted PEEK- (PEEK) and (3) titanium implant (Ti) and an empty sham site. At 12 weeks, removal torque of all implants and biological investigation with qPCR was performed. The implant surfaces were analyzed prior to insertion with interferometry, SEM and XPS.

RESULTS: The interferometry analysis showed that there was no difference in roughness for the uncoated PEEK compared to the ZrP coated PEEK implants. The titanium implants were considerably smoother (Sa= 0.23 µm) than the uncoated Sa= 1.11 µm) and ZrP coated PEEK implants (Sa= 1.12 µm). SEM analysis on the PEEK implants corroborated the interferometry results; no difference in structure between the uncoated vs. the ZrP coated PEEK was visible on the micrometer level. At higher magnifications, the ZrP coating was visible in the SEM as a thin, porous network. All tested implants displayed osseointegration with the highest RTQ for nano-ZrP (18.4 Ncm) followed by PEEK (14.5 Ncm) and Ti (11.5 Ncm). All implants activated the immune system, with elevated macrophage and M2 macrophage qPCR markers at 12 weeks compared to the sham site.

CLINICAL SIGNIFICANCE: Nano-ZrP coating improves osseointegration of blasted PEEK implants at 12 weeks of follow-up. Osseointegration of titanium, PEEK and nano-ZrP PEEK is not a normal bone healing process, but rather a shield-off mechanism that appears to be regulated by the innate immune system.

Place, publisher, year, edition, pages
Mosher & Linder, Inc., 2022
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-56285 (URN)000893228600008 ()35798711 (PubMedID)
Available from: 2022-11-29 Created: 2022-11-29 Last updated: 2023-09-07Bibliographically approved
Duddeck, D. U., Albrektsson, T., Wennerberg, A., Larsson, C., Mouhyi, J. & Beuer, F. (2021). Quality Assessment of Five Randomly Chosen Ceramic Oral Implant Systems: Cleanliness, Surface Topography, and Clinical Documentation. International Journal of Oral & Maxillofacial Implants, 36(5), 863-874
Open this publication in new window or tab >>Quality Assessment of Five Randomly Chosen Ceramic Oral Implant Systems: Cleanliness, Surface Topography, and Clinical Documentation
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2021 (English)In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 36, no 5, p. 863-874Article in journal (Refereed) Published
Abstract [en]

Purpose: After some initial setbacks in the 1970s, ceramic implants seem to be a promising alternative to titanium implants. Since the surface of an implant system represents the interface to surrounding biologic structures, the study focuses on cleanliness and surface topography. Clinical documentation of the corresponding systems completes the picture and allows a better evaluation of zirconia implant systems. Materials and Methods: Five different ceramic implant systems were selected randomly and purchased via blind-shopping: Z5s (Z-Systems), ZiBone (COHO), W implant (TAVDental), ceramic. implant (vitaclinical), and BioWin!/Standard Zirkon Implantat (Champions-Implants/ZV3 system). Three samples of each implant system underwent scanning electron microscopy (SEM) imaging and elemental analysis (EDS). Where appropriate, subsequent Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS) was performed to identify the chemical nature of impurities. Surface topography was evaluated, and a search for clinical trials in the PubMed database, on the websites and by written request to each dental implant manufacturer, was performed. Results: Surfaces of Champions implants (ZV3) and Z-Systems implants were relatively clean, whereas the other investigated surfaces of vitaclinical, TAV Dental, and ZiBone implants all displayed organic contaminations on their surfaces. Four of the investigated ceramic implants showed a moderately rough implant surface. Only the vitaclinical ceramic.implant had minimal surface roughness. Three ceramic designs—vitaclinical, ZV3, and Z-Systems—had clinical trials documented with up to 3 years of follow-up and results varying between 82.5% and 100% survival. TAV Dental W and ZiBone implant systems lacked properly conducted clinical recording of results. Conclusion: The results of this study showed that it is technically possible to produce zirconia implants that are largely residue-free. On the other hand, the variety of significant residues found in this analysis raises concerns, as contamination may lead to undesirable biologic effects. The lack of clinical studies in peer-reviewed journals does not seem to be relevant for the approval of marketing, nor does the lack of surface cleanliness. In the authors’ opinion, a critical analysis of these aspects should be included in a more stringent future analysis prior to the marketing of oral implant systems.

Place, publisher, year, edition, pages
Quintessence, 2021
Keywords
ceramic implants, dental implants, implant contamination, implant surface, scanning electron microscopy, surface, surface properties, zirconia
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-46742 (URN)10.11607/jomi.8837 (DOI)000711661100006 ()34698711 (PubMedID)2-s2.0-85120957123 (Scopus ID)
Available from: 2021-11-09 Created: 2021-11-09 Last updated: 2024-02-05Bibliographically approved
Albrektsson, T., Dahlin, C., Reinedahl, D., Tengvall, P., Trindade, R. & Wennerberg, A. (2020). An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper. International Journal of Oral & Maxillofacial Implants, 35(3), 495-502
Open this publication in new window or tab >>An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper
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2020 (English)In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 35, no 3, p. 495-502Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this paper is to present evidence that supports the notion that the primary reason behind marginal bone loss and implant failure is immune-based and that bacterial actions in the great majority of problematic cases are of a secondary nature. Materials and Methods: The paper is written as a narrative review. Results: Evidence is presented that commercially pure titanium is not biologically inert, but instead activates the innate immune system of the body. For its function, the clinical implant is dependent on an immune/inflammatory defense against bacteria. Biologic models such as ligature studies have incorrectly assumed that the primary response causing marginal bone loss is due to bacterial action. In reality, bacterial actions are secondary to an imbalance of the innate immune system caused by the combination of titanium implants and ligatures, ie, nonself. This immunologic imbalance may lead to marginal bone resorption even in the absence of bacteria. Conclusion: Marginal bone loss and imminent oral implant failure cannot be properly analyzed without a clear understanding of immunologically caused tissue responses.

Place, publisher, year, edition, pages
QUINTESSENCE PUBLISHING CO INC, 2020
Keywords
biomaterials, failure analysis, immunologic reactions, peri-implantitis, review (narrative)
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-17501 (URN)10.11607/jomi.8218 (DOI)000532806800008 ()32406645 (PubMedID)2-s2.0-85084717808 (Scopus ID)
Available from: 2020-06-16 Created: 2020-06-16 Last updated: 2024-02-05Bibliographically approved
Gjelvold, B., Kisch, J., Mohammed, D. M., Chrcanovic, B. R., Albrektsson, T. & Wennerberg, A. (2020). Immediate Loading of Single Implants, Guided Surgery, and Intraoral Scanning: A Nonrandomized Study. International Journal of Prosthodontics, 33(5), 513-522
Open this publication in new window or tab >>Immediate Loading of Single Implants, Guided Surgery, and Intraoral Scanning: A Nonrandomized Study
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2020 (English)In: International Journal of Prosthodontics, ISSN 0893-2174, E-ISSN 1139-9791, Vol. 33, no 5, p. 513-522Article in journal (Refereed) Published
Abstract [en]

Purpose: To compare clinical and esthetic outcomes between immediately loaded single implants placed with and without a fully guided surgical procedure. Materials and Methods: Patients with a missing maxillary tooth (second premolar to second premolar) were considered for inclusion in this 1-year prospective nonrandomized study. Exclusion criteria were general health contraindications for oral surgery besides the need for bone grafting or ridge augmentation. One group received digital implant planning, fully guided surgery, and immediate loading (DIL). The other group received freehand surgery and immediate loading (IL). Outcome measures were implant survival, marginal bone loss, soft tissue changes, papilla index, pink and white esthetic scores (PES and WES, respectively), and patient-reported outcome measures (PROMs). Results: Two of 21 implants failed in the DIL group soon after placement, resulting in a 1-year implant survival rate of 90.5%, while no implants failed in the IL group. Significantly higher papilla index scores and lower soft tissue changes were found for the DIL group compared to the IL group. No differences were found after 1 year regarding marginal bone loss, PES, WES, or PROMs. Conclusion: Within the limitations of this study, immediate loading in combination with fully guided surgery might negatively affect implant survival. Immediate loading, fully guided surgery, and a digital workflow appear to have a positive effect on early soft tissue adaptation.

Place, publisher, year, edition, pages
Quintessence publishing co inc, 2020
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-18620 (URN)10.11607/ijp.6701 (DOI)000571425900005 ()32956432 (PubMedID)2-s2.0-85091458761 (Scopus ID)
Available from: 2020-10-13 Created: 2020-10-13 Last updated: 2024-02-05Bibliographically approved
Aparicio, C., Lopez-Piriz, R. & Albrektsson, T. (2020). ORIS Criteria of Success for the Zygoma-Related Rehabilitation: The (Revisited) Zygoma Success Code. International Journal of Oral & Maxillofacial Implants, 35(2), 366-378
Open this publication in new window or tab >>ORIS Criteria of Success for the Zygoma-Related Rehabilitation: The (Revisited) Zygoma Success Code
2020 (English)In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 35, no 2, p. 366-378Article in journal (Refereed) Published
Abstract [en]

Zygomatic-related implant rehabilitation differs from traditional implant treatment in biomechanics, clinical procedures, outcomes, and eventual complications such as soft tissue incompetence or recession that may lead to recurrent sinus/soft tissue complications. The extreme maxillary atrophy that indicates the use of zygomatic implants prevents use of conventional criteria to describe implant success/failure. Currently, results and complications of zygomatic implants reported in the literature are inconsistent and lack a standardized systematic review. Moreover, protocols for the rehabilitation of the atrophic maxilla using zygomatic implants have been in continuous evolution. The current zygomatic approach is relatively new, especially if the head of the zygomatic implant is located in an extramaxillary area with interrupted alveolar bone around its perimeter. Specific criteria to describe success/survival of zygomatic implants are necessary, both to write and to read scientific literature related to zygomatic implant-based oral rehabilitations. The aim of this article was to review the criteria of success used for traditional and zygomatic implants and to propose a revisited Zygomatic Success Code describing specific criteria to score the outcome of a rehabilitation anchored on zygomatic implants. The ORIS acronym is used to name four specific criteria to systematically describe the outcome of zygomatic implant rehabilitation: offset measurement as evaluation of prosthetic positioning; rhino-sinus status report based on a comparison of presurgical and postsurgical cone beam computed tomography in addition to a clinical questionnaire; infection permanence as evaluation of soft tissue status; and stability report, accepting as success some mobility until dis-osseointegration signs appear. Based on these criteria, the assessment of five possible conditions when evaluating zygomatic implants is possible.

Place, publisher, year, edition, pages
QUINTESSENCE PUBLISHING CO INC, 2020
Keywords
criteria of success, ORIS, review (narrative), ZAGA, zygomatic implants, zygomatic success code
National Category
Clinical Medicine
Identifiers
urn:nbn:se:mau:diva-17079 (URN)10.11607/jomi.7488 (DOI)000519127500017 ()32142574 (PubMedID)2-s2.0-85081944964 (Scopus ID)
Available from: 2020-04-20 Created: 2020-04-20 Last updated: 2024-02-05Bibliographically approved
Aparicio, C., López-Piriz, R. & Albrektsson, T. (2020). Success Criteria in Zygomatic Implant Dentistry. In: James Chow (Ed.), Zygomatic Implants: Optimization and Innovation (pp. 211-233). Springer
Open this publication in new window or tab >>Success Criteria in Zygomatic Implant Dentistry
2020 (English)In: Zygomatic Implants: Optimization and Innovation / [ed] James Chow, Springer, 2020, p. 211-233Chapter in book (Refereed)
Abstract [en]

The extreme maxillary atrophy that indicates the use of zygomatic implants (ZI) is associated with resorptive changes in both alveolar and basal bone, and prevents direct placement of conventional endosseous implants. Therefore, using conventional criteria to describe implant success/failure is not sensible for ZI. Moreover, protocols for the rehabilitation of the atrophic maxilla using ZI have been continuously evolving to overcome initial shortcomings of early initial shortcomings of early techniques. The current zygomatic approach is relatively new, especially if the head of the ZI is located in an extra-maxillary buccal position to the alveolar crest with no alveolar bone around its perimeter. The zygomatic-related rehabilitation protocol differs from conventional implant therapy with respect to biomechanics, clinical procedures, outcomes, and eventual complications such as soft tissue incompetence or recession that may lead to recurrent sinus/soft tissue infections and aesthetic patient complaints. Currently, the way in which results and complications of ZI are reported in the scientific literature is inconsistent and lacks a standardized approach. Specific criteria to describe success/survival of ZI, including a standardized way to report on rhinosinus pathology associated with ZI, is necessary. The aim of this chapter is to critically review success criteria used for conventional and zygomatic implants. Finally, a revisited Zygomatic Success Code describing specific criteria to score the outcome of a rehabilitation anchored on ZI is proposed. The authors use the ORIS acronym to name four specific criteria to systematically describe the outcome of ZI rehabilitation:

  • Offset: evaluation of prosthetic success based on the final positioning of the zygomatic implant with respect to the middle of the alveolar crest in the horizontal dimension.
  • Rhinosinus status report: a pre, and postsurgical cone-beam computed tomography comparative approach to evaluating whether sinuses are healthy; a clinical questionnaire where “yes” and “no” answers can be given.
  • Infection permanence related to dehiscence: an evaluation of soft tissue signs of infection or dehiscence on a grading scale based on reference photographs.
  • Stability report: accepting as success some mobility until dis-osseointegration signs of rotation or apical pain present.
Place, publisher, year, edition, pages
Springer, 2020
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-64553 (URN)10.1007/978-3-030-29264-5_11 (DOI)2-s2.0-85149570754 (Scopus ID)978-3-030-29263-8 (ISBN)978-3-030-29266-9 (ISBN)978-3-030-29264-5 (ISBN)
Available from: 2023-12-18 Created: 2023-12-18 Last updated: 2023-12-18Bibliographically approved
Reinedahl, D., Galli, S., Albrektsson, T., Tengvall, P., Johansson, C. B., Hammarström Johansson, P. & Wennerberg, A. (2019). Aseptic Ligatures Induce Marginal Peri-Implant Bone Loss-An 8-Week Trial in Rabbits (ed.). Journal of Clinical Medicine, 8(8)
Open this publication in new window or tab >>Aseptic Ligatures Induce Marginal Peri-Implant Bone Loss-An 8-Week Trial in Rabbits
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2019 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 8, no 8Article in journal (Refereed)
Abstract [en]

The clinical value of ligature-induced experimental peri-implantitis studies has been questioned due to the artificial nature of the model. Despite repeated claims that ligatures of silk, cotton and other materials may not induce bone resorption by themselves; a recent review showed that the tissue reaction toward them has not been investigated. Hence, the current study aimed to explore the hard and soft tissue reactions toward commonly used ligature materials. A total of 60 dental implants were inserted into the femur ( = 20) and tibia ( = 40) of 10 rabbits. The femoral implants were ligated with sterile 3-0 braided silk in one leg and sterile cotton retraction chord in the other leg. The tibial implants were ligated with silk or left as non-ligated controls. All wounds were closed in layers. After a healing time of 8 weeks, femoral (silk versus cotton) and proximal tibial (silk versus non-ligated control) implants were investigated histologically. Distal tibial (silk versus non-ligated control) implants were investigated with real time polymerase chain reaction (qPCR). The distance from the implant-top to first bone contact point was longer for silk ligated implants compared to non-ligated controls ( = 0.007), but did not vary between cotton and silk. The ligatures triggered an immunological reaction with cell infiltrates in close contact with the ligature materials, adjacent soft tissue encapsulation and bone resorption. qPCR further demonstrated an upregulated immune response toward the silk ligatures compared to non-ligated controls. Silk and cotton ligatures provoke foreign body reactions of soft tissue encapsulation type and bone resorption around implants in the absence of plaque.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
aseptic loosening, dental implant, ligature induced peri-implantitis, marginal bone loss, osseointegration
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15787 (URN)10.3390/jcm8081248 (DOI)000483737700035 ()31426572 (PubMedID)2-s2.0-85087705030 (Scopus ID)30038 (Local ID)30038 (Archive number)30038 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Trindade, R., Albrektsson, T., Galli, S., Prgomet, Z., Tengvall, P. & Wennerberg, A. (2019). Bone Immune Response to Materials, Part II: Copper and Polyetheretherketone (PEEK) Compared to Titanium at 10 and 28 Days in Rabbit Tibia (ed.). Journal of Clinical Medicine, 8(6), Article ID 814.
Open this publication in new window or tab >>Bone Immune Response to Materials, Part II: Copper and Polyetheretherketone (PEEK) Compared to Titanium at 10 and 28 Days in Rabbit Tibia
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2019 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 8, no 6, article id 814Article in journal (Refereed)
Abstract [en]

Abstract: Osseointegration is likely the result of an immunologically driven bone reaction to materials such as titanium. Osseointegration has resulted in the clinical possibility to anchor oral implants in jaw bone tissue. However, the mechanisms behind bony anchorage are not fully understood and complications over a longer period of time have been reported. The current study aims at exploring possible differences between copper (Cu) and polyetheretherketone (PEEK) materials that do not osseointegrate, with osseointegrating cp titanium as control. The implants were placed in rabbit tibia and selected immune markers were evaluated at 10 and 28 days of follow-up. Cu and PEEK demonstrated at both time points a higher immune activation than cp titanium. Cu demonstrated distance osteogenesis due to a maintained proinflammatory environment over time, and PEEK failed to osseointegrate due to an immunologically defined preferential adipose tissue formation on its surface. The here presented results suggest the description of two different mechanisms for failed osseointegration, both of which are correlated to the immune system.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
biomaterial, bone, osseointegration, immune, implant, healing, titanium, PEEK, Cu
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15822 (URN)10.3390/jcm8060814 (DOI)000475349300058 ()31181635 (PubMedID)2-s2.0-85076136759 (Scopus ID)28805 (Local ID)28805 (Archive number)28805 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Albrektsson, T., Becker, W., Coli, P., Jemt, T., Mölne, J. & Sennerby, L. (2019). Bone loss around oral and orthopedic implants: An immunologically based condition (ed.). Clinical Implant Dentistry and Related Research, 21(4), 786-795
Open this publication in new window or tab >>Bone loss around oral and orthopedic implants: An immunologically based condition
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2019 (English)In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 21, no 4, p. 786-795Article, review/survey (Refereed)
Abstract [en]

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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
adverse immune reaction, bone loss, normal immune reaction, oral implants, orthopedic implants
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-962 (URN)10.1111/cid.12793 (DOI)000481415400034 ()31134756 (PubMedID)2-s2.0-85070693528 (Scopus ID)30230 (Local ID)30230 (Archive number)30230 (OAI)
Available from: 2020-02-27 Created: 2020-02-27 Last updated: 2024-02-06Bibliographically approved
Albrektsson, T., Jemt, T., Molne, J., Tengvall, P. & Wennerberg, A. (2019). On inflammation-immunological balance theory-A critical apprehension of disease concepts around implants: Mucositis and marginal bone loss may represent normal conditions and not necessarily a state of disease (ed.). Clinical Implant Dentistry and Related Research, 21(1), 183-189
Open this publication in new window or tab >>On inflammation-immunological balance theory-A critical apprehension of disease concepts around implants: Mucositis and marginal bone loss may represent normal conditions and not necessarily a state of disease
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2019 (English)In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 21, no 1, p. 183-189Article, review/survey (Refereed)
Abstract [en]

Background Oral implants have displayed clinical survival results at the 95%-99% level for over 10 years of follow up. Nevertheless, some clinical researchers see implant disease as a most common phenomenon. Oral implants are regarded to display disease in the form of mucositis or peri-implantitis. One purpose of the present article is to investigate whether a state of disease is necessarily occurring when implants display soft tissue inflammation or partially lose their bony attachment. Another purpose of this article is to analyze the mode of defense for implants that are placed in a bacteria rich environment and to analyze when an obtained steady state between tissue and the foreign materials is disturbed. Materials and Methods The present article is authored as a narrative review contribution. Results Evidence is presented that further documents the fact that implants are but foreign bodies that elicit a foreign body response when placed in bone tissue. The foreign body response is characterized by a bony demarcation of implants in combination with a chronic inflammation in soft tissues. Oral implants survive in the bacteria-rich environments where they are placed due to a dual defense system in form of chronic inflammation coupled to immunological cellular actions. Clear evidence is presented that questions the automatic diagnostics of an oral implant disease based on the finding of so called mucositis that in many instances represents but a normal tissue response to foreign body implants instead of disease. Furthermore, neither is marginal bone loss around implants necessarily indicative of a disease; the challenge to the implant represented by bone resorption may be successfully counteracted by local defense mechanisms and a new tissue-implant steady state may evolve. Similar reactions including chronic inflammation occur in the interface of orthopedic implants that display similarly good long-term results as do oral implants, if mainly evaluated based on revision surgery in orthopedic cases. The most common mode of failure of orthopedic implants is aseptic loosening which has been found coupled to a reactivation of the inflammatory- immune system. Conclusions Implants survive in the body due to balanced defense reactions in form of chronic inflammation and activation of the innate immune system. Ten year results of oral and hip /knee implants are hence in the 90+ percentage region. Clinical problems may occur with bone resorption that in most cases is successfully counterbalanced by the defense/healing systems. However, in certain instances implant failure will ensue characterized by bacterial attacks and/or by reactivation of the immune system that now will act to remove the foreign bodies from the tissues.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
crestal bone loss, defense against disease, foreign body reaction, immunologic reaction, inflammation, osseointegration, peri-implantitis
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-16195 (URN)10.1111/cid.12711 (DOI)000458169600027 ()30592373 (PubMedID)2-s2.0-85059275265 (Scopus ID)29439 (Local ID)29439 (Archive number)29439 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
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