Fig. 3

Peri-implantitis is a multifactorial condition affecting soft tissue and bone around the implant and is resulting from an imbalanced interaction between the pathogen and the host immune response. The inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone injury of peri-implant tissue causes an inflammatory response firstly mediated by activation of innate immune cells such as macrophages, dendritic cells, mast cells, and neutrophils, that induces inflammatory process, leading both microbiota disrupting and osteolysis process inducing. The neutrophils promote the release of pro-inflammatory citokines IL-1 and TNF-α, which in turn activate the osteolytic and inflammatory tissue damage observed in peri-implantitis, while macrophages release participate in the inflammation exacerbation and consequent accelerating osteolysis. The bone loss creates an environment to biofilm formation