Purpose: Peri-implantitis is a growing problem because of the increasing number of patients rehabilitated with oral implants. Predictors of susceptibility to peri-implantitis and pharmacological agents for the treatment of inflammatory peri-implantitis are of significant interest to the practicing community. The goal of this paper is to review the current literature relating to the impact of genotypes and immune reactivity on peri-implant inflammation and to identify the potential use of anti-inflammatory and immunomodulatory drugs.
Materials and methods: A MEDLINE search of the relevant literature was performed and all related articles were evaluated.
Results: There was little support in the literature for a specific genotype or phenotype of immune reactivity that could be reliably used as an indicator of susceptibility to peri-implant disease. Furthermore, no currently available anti-inflammatory drugs were identified that could be used long term for the treatment of inflammatory peri-implantitis. New pathways for the control of inflammation have been identified that have the potential for new pharmacologic therapies. The basis for these new discoveries is reviewed in some detail.
Conclusions: While there are varying reports of associations of specific genotypes with peri-implantitis, the studies are inconsistent and generally underpowered precluding any interpretable pattern. Inflammatory peri-implantitis is associated with increased local inflammation, but no consistent systemic inflammatory markers have been identified. To date, no safe and effective anti-inflammatory therapy is known for the treatment of peri-implantitis. However, a new class of molecules in development for the active regulation and resolution of inflammation shows theoretical promise for the treatment of inflammatory lesions.
Keywords: genetic markers, inflammation, lipoxins, peri-implantitis, resolvins