An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper
An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper
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DOI：
10.11607/jomi.8218
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发表时间：
2020-05-01
影响因子：
2
通讯作者：
Wennerberg, Ann
中科院分区：
文献类型：
--
作者：
Albrektsson, Tomas;Dahlin, Christer;Wennerberg, Ann
目的：本文的目的是提供证据，支持以下观点：边缘骨丢失和种植体失败的主要原因是基于免疫的，而大多数问题病例中的细菌作用是次要的。材料和方法：本文是一篇叙述性评论。结果：有证据表明，商业纯钛不具有生物惰性，而是可以激活人体的先天免疫系统。就其功能而言，临床植入物依赖于针对细菌的免疫/炎症防御。诸如结扎研究之类的生物模型错误地假设导致边缘骨丢失的主要反应是由于细菌作用。事实上，细菌的作用是由钛植入物和结扎线（即非自身）的组合引起的先天免疫系统失衡的继发性。即使在没有细菌的情况下，这种免疫失衡也可能导致边缘骨吸收。结论：如果没有清楚地了解免疫引起的组织反应，就无法正确分析边缘骨丢失和即将发生的口腔种植失败。
Purpose: The purpose of this paper is to present evidence that supports the notion that the primary reason behind marginal bone loss and implant failure is immune-based and that bacterial actions in the great majority of problematic cases are of a secondary nature. Materials and Methods: The paper is written as a narrative review. Results: Evidence is presented that commercially pure titanium is not biologically inert, but instead activates the innate immune system of the body. For its function, the clinical implant is dependent on an immune/inflammatory defense against bacteria. Biologic models such as ligature studies have incorrectly assumed that the primary response causing marginal bone loss is due to bacterial action. In reality, bacterial actions are secondary to an imbalance of the innate immune system caused by the combination of titanium implants and ligatures, ie, nonself. This immunologic imbalance may lead to marginal bone resorption even in the absence of bacteria. Conclusion: Marginal bone loss and imminent oral implant failure cannot be properly analyzed without a clear understanding of immunologically caused tissue responses.