Peri-implantitis around failing and/or ailing implants: Histopathological findings

Aim: peri-implant disease refers to the pathological inflammatory changes that take place in the tissue surrounding implants. The aim of this study was to pathologically evaluate prei-implantitis around failing and/or ailing implants. Methods: This retrospective cohort study includes 100 biopsies of peri-implantitis around failing and/or ailing implants. The study was conducted on consecutive patients (45 women and 29 men), aged 21 to 78 years (mean 55.2 years) and the mean period time between implantation and biopsy was 10.1 years (range 0.25-16.6 years). All 100 biopsies were submitted for histopathological diagnosis. Results: biopsy results included non-specific inflammatory reaction (40.3%), actinomycosis (30.7%), pyogenic granuloma (18.8%) and giant cell granuloma (12%). Conclusion: The clinical presentation of peri-implantitis in failing and/or ailing implants exhibits microscopic evidence of potentially aggressive reactive lesions rather than simple inflammation in the majority of cases. These lesions are recognized as potentially aggressive when they occur around teeth; however, their contribution to the failure of implants has not been investigated before. To our knowledge, this study presents the largest series of peri-implant biopsies with pathological examination. Further investigation is required to better understand the role of reactive lesions as well as actinomycosis in peri-implantitis and adjust treatment according to the results.