In general, dental implants have a high degree of success. But when dental implants fail, the leading cause is peri-implantitis. But what causes peri-implantitis?
Researchers looking into this question found high levels of titanium in diseased tissue. They suspect that the presence of titanium contributes to the progression of the disease. This may trigger titanium allergy and may be partly responsible for dental implant failure.
Peri-Implantitis: Gum Disease or Something Else?
Peri-implantitis is a condition that affects dental implants. In many ways, it’s very similar to periodontal disease, which is part of the reason why the names are so similar. The prefix “peri” simply means near or around. So the names simply refer to the fact that the disease is either around the implant or around the tooth.
The two conditions present in similar ways: inflammation of the gums, bleeding, gum recession, bone loss, and ultimately loss of the implant or tooth. Because of this, it’s often assumed that peri-implantitis is simply gum disease around the implant. In other words, oral bacteria infect tissue around the implant, causing problems with the gums and bone.
However, some researchers suspect other factors might be in play, such as titanium. Although titanium can integrate with the bone, it is still a heavy metal and some people have serious allergic responses to it. Could this encourage gum inflammation and lead to serious peri-implantitis?
High Levels of Titanium Found around Implants
Researchers in Sweden examined 24 patients. Thirteen came in for treatment of peri-implantitis and 11 came in for treatment of gum disease. They took samples of the inflamed gum tissue for both sets of patients and analyzed them for titanium.
They found that the tissues of peri-implantitis patients had about 100 μg/g of titanium, compared to about 1 μg/g for the regular gum disease tissue.
Is Titanium Allergy Causing Peri-Implantitis?
Of course, this study has several limitations that prevent us from making solid conclusions. First, although the high level of titanium in peri-implant tissue is striking, there’s no evidence that it’s actually causing any problem. In this study, researchers didn’t take any samples from people with healthy implants. As researchers point out, it would be unethical to biopsy people with healthy implants, when that might cause problems. Therefore, they couldn’t tie high titanium levels to peri-implantitis, just the presence of dental implants.
In their conclusion, authors said, “We support the hypothesis that peri-implantitis is an infectious disease induced by a bacterial biofilm on the implant surface, but the presence of titanium particles in the peri-implant tissue might further enhance the immunological response and aggravate the loss of supporting bone.” They reaffirm that peri-implantitis is most likely related to infection. They also avoid explicitly talking about a titanium allergy, although since a definition of allergy is ”a damaging immune response by the body to a substance . . . to which it has become hypersensitive,” it’s clear that’s what they mean, even though they don’t use the word.
Researchers recommend not scaling implants during cleaning and especially during the early stages of peri-implantitis to avoid releasing titanium into the tissue around the implant.
Dental Implants in Rochester, NY without Titanium
Another way to avoid titanium exposure is to get a dental implant that is not made of titanium. At Contemporary Dentistry, we follow holistic dentistry guidelines for safer materials. We offer implants with less titanium and some completely without titanium. We offer implants with a titanium-zirconium alloy, as well as those made with zirconia, a ceramic that is stronger than titanium. These can reduce inflammation around the dental implant.