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An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper
Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces. Univ Gothenburg, Dept Biomat, Gothenburg, Sweden.
NU Hosp Org, Dept Oral & Maxillofacial Surg ENT, Trollhattan, Sweden; Univ Gothenburg, Dept Biomat, Gothenburg, Sweden.
Univ Gothenburg, Dept Prosthodont, Gothenburg, Sweden.
Univ Gothenburg, Dept Biomat, Gothenburg, Sweden.
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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. Vol. 35, no 3, p. 495-502
Keywords [en]
biomaterials, failure analysis, immunologic reactions, peri-implantitis, review (narrative)
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-17501DOI: 10.11607/jomi.8218ISI: 000532806800008PubMedID: 32406645Scopus ID: 2-s2.0-85084717808OAI: oai:DiVA.org:mau-17501DiVA, id: diva2:1441863
Available from: 2020-06-16 Created: 2020-06-16 Last updated: 2024-06-17Bibliographically approved

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Albrektsson, TomasWennerberg, Ann

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