Congratulations to Dr. Blansett on his recent publication “Foreign Bodies Associated with Peri-Implantitis Human Biopsies” in the Journal of Periodontology! This article identifies foreign body reactions to titanium metal and dental cement around dental implants affected by peri-implantitis.
As we all know, peri-implantitis is becoming more and more of a concern for both the implant surgeons and restorative dentists. The book is literally being written about the best treatment strategies and approaches to correct peri-implant bone defects once they are identified. Part of the problem treating peri-implantitis is we do not have a clear understanding of its etiology. Like periodontitis, some patients seem to be more susceptible to peri-implantitis than others. There are a myriad of possible factors and/or combination of factors to consider, and each is slowly being unraveled by researchers around the world.
To summarize this study, patients with advanced peri-implantitis that were scheduled for implant removal had soft tissue biopsies of the adjacent peri-implant tissues during the procedure. These tissues were then subjected to histologic evaluation, scanning electron microscopy, and energy dispersive X-ray spectrometry to characterize the inflammatory cell type, identify particles embedded in the soft tissues, and characterize their elemental composition. The elements identified are consistent with titanium oxide and dental cement. How these elements became embedded in these peri-implant tissues is still not totally clear. Possible reasons are from friction between the bone and implant during implant placement, corrosion of the titanium metal in the oral environment with subsequent leaching of metal ions into surrounding tissues, or during attempts in maintenance visits to remove identified retained cement. However the exact mechanism they got there, these foreign bodies were recognized by the immune system and in the process of responding to the foreign debris more peri-implant bone was destroyed. He completed this study with Dr. Thomas G. Wilson, Jr and Dr. Pilar Valderrama, both periodontists in Dallas, TX and leading researchers globally on peri-implant diseases.
This study may provide important evidence on the chronic nature of peri-implantitis and is the one of the very first studies that involved human subjects. Dr. Blansett has also published an additional review article on peri-implantitis and remains active clinically in identifying and treating affected implants. For more information or if you have a patient you would like to refer for peri-implant disease(s) please contact us.
Link to current article: http://www.joponline.org/doi/pdf/10.1902/jop.2014.140363
Link to review article: http://www.ncbi.nlm.nih.gov/pubmed/24894571