To review the evolving shift in peri-implantitis research from traditional mechanical debridement toward host-modulatory and immunopharmacological concepts, focusing on molecular pathogenesis, candidate therapeutic targets, and advanced drug delivery systems requiring further validation.
Key Findings:
Peri-implantitis is recognized as an immunologically complex condition.
Single-cell studies suggest significant cell-interaction patterns, such as the CXCL13+ fibroblast-CXCR2+ neutrophil axis.
Candidate therapeutic strategies include targeted anti-cytokine biologics, specialized pro-resolving mediators, and macrophage-directed approaches.
Advanced delivery systems like stimuli-responsive hydrogels and exosome-based platforms may support localized treatment.
Machine-learning models show promise for risk stratification but require prospective clinical validation.
Interpretation:
Emerging immunopharmacological strategies, along with biomarker diagnostics and artificial intelligence, may facilitate a shift towards proactive and personalized care for peri-implantitis, particularly through targeted interventions.
Limitations:
Most therapeutic strategies remain preclinical or in early translational stages, necessitating validation through randomized controlled trials and longitudinal studies.
The mechanistic relevance and clinical utility of proposed interventions require validation in rigorous studies.
Conclusion:
The future of peri-implantitis management may lie in understanding and modulating the interplay between microbial biofilms, host immune responses, and biomaterial interactions, emphasizing the need for innovative therapeutic strategies.
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