Peri-Implantitis in Relation to Titanium Corrosion: Current Status and Future Perspectives

Although dental implants have a high success rate, their increased usage has consequently led to increasing complications including peri-implantitis. This review provides a thorough overview of peri-implantitis: definition, risk factors, the role of corrosion in peri-implantitis, treatment, prevention, and future research directions. An online database search was conducted through PubMed, Embase, Scopus, Web of Science and Google Scholar to compile research articles using the keywords: peri-implantitis, dental implant, corrosion, tribocorrosion, titanium, osseointegration, prevention, and treatment and relevant studies were included. Titanium has high biocompatibility due to the ability to form a protective oxide layer. Problems arise as the layer is harmed by corrosion which is influenced by several factors including high concentrations of electrolytes, acidic pH, and/or lipopolysaccharides. Though the relationship between titanium products (ions and particles) and inflammation is still unclear, there is evidence that titanium products can be pro-inflammatory. Current investigations of implant coatings and surface modifications focus mainly on the prevention of corrosion, but no universal usage is found. Future studies should generate a deeper understanding on the specific prevention mechanisms of corrosion as this might reduce peri-implant inflammation.