Molecular Alterations in the Peri-Implantitis Junctional Epithelium

Peri-implantitis is a biofilm-mediated inflammatory reaction that is characterized by bleeding on probing and/or suppuration with progressive loss of supporting bone beyond the initial biological remodeling that occurs during the healing period (Zitzmann & Berglundh, 2008). In the 2014 American Academy of Periodontology (AAP) Report on peri-implant mucositis and peri-implantitis, it was reported that the prevalence of peri-implantitis to be as high as 36.6% (American Academy of Periodontology Academy Report, 2013). A systematic review of the literature from 2011-2014 identified the prevalence of peri-implantitis to range from 10 to 40% (Charalampakis et al., 2014). With over five (5) million dental implants placed annually in the United States, and the knowledge that the incidence of peri-implantitis increases with increasing age of the implant, clarification of the genetic profile of the peri-implant lesion is necessary (American Academy of Implant Dentistry 2006; Roos-Jansaker, 2007). The peri-implant soft tissue is composed of a keratinized oral epithelium, a sulcular epithelium, a junctional epithelium and a connective tissue attachment (Ivanovski & Lee, 2017). The focus of this project is the junctional or barrier epithelium. This is a component of the attachment apparatus and has been shown to begin forming after 1-2 weeks of wound healing and reaches maturity at 6-8 weeks (Berglundh et al., 2007). The integrity of this epithelial attachment allows for and maintains osteointegration. In peri-implantitis, this epithelial attachment is impaired (Klinge et al., 2006). In this study we compared the molecular profile of the junctional epithelium in peri-implantitis with that of the healthy implant. Our goal is to improve the understanding of peri-implantitis at the molecular and genetic levels in order to ultimately enhance this field of study.