Biological Communications Between Implants and Periodontal Tissues

At present, attention is directed to increase the bone to implant contact (BIC) and minimize the marginal bone loss by modifying the root part of titanium implant using chemical and texture surface treatments. In the present review, we evaluate to what extent the titanium implant surface treatments are targeted to achieve biological attachment and connectivity similar to ankylosed teeth.

We find that the re-implanted tooth that undergoes ankylosis to alveolar bone and re-attachment of marginal gingiva by cellular and fibrous biological connectivity is a desirable model to seek similar implant attachment to the periodontium. In fact, the root part of the implant that is undergoing osseointegration resembles direct deposition of bone onto tooth cementum. It seems that activating cellular attachment of soft connective tissue of marginal gingiva is less predictable and needs the application of nano technologies to enhance attraction of these cells to the trans-gingival connector. Such cellular physiologically strained attachment will develop normal communicative pathways between implant and periodontium.

This paper provides a new perspective on the model that should guide the development of future dental implants. Surface modifications of implants should facilitate their attachment both to the alveolar bone and the marginal gingiva, mimicking the physiological process involved in re-implanted teeth.