Translational Multimodal Strategy for Peri-Implant Disease Prevention

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Dental implants have become an important routine component of dental practice with over five million fixtures placed annually in the United States and this number is expected to increase significantly in the future. The peri-implant soft tissue interface is less effective than natural teeth in resisting bacterial invasion, enhancing vulnerability to subsequent peri-implant disease. Peri-implant diseases are inflammatory conditions affecting the soft/hard tissues surrounding a functional dental implant. Plenty of experimental evidence indicates that the accumulation of dental plaque at the soft tissue-implant interface and the subsequent local inflammatory response seems to be key in the pathogenesis of peri-implant mucositis. Furthermore, in certain individuals, it will progress to peri-implantitis, resulting in alveolar bone loss and implant failure. The goal of this application is to create a novel dental implant construct that renders the implant-supported restoration antibiofilm while providing a tight gingival tissue-implant seal that serves as a barrier to bacterial invasion. This smart dental implant system is a battery-less system that converts biomechanical forces from human oral motions (e.g., chewing or tooth-brushing) into electrical energy and powers light-emitting diodes that enable in situ phototherapy. When used in combination with a long-lasting antibiofilm restorative surface, this self-powered precision phototherapy system circumvents problems with the use of conventional antimicrobials. Ongoing studies indicate that red and near-infrared light is effective in maintaining human gingival tissue cell viability in the face of mono- and multi-microbial challenges. Furthermore, the antibiofilm restorative surface almost completely inhibits bacterial colonization. Based on these exciting supporting data, we hypothesize that force- powering of piezoelectric crystals to produce red and near-infrared light combined with bacterial anti-adhesive restorations creates an anti-inflammatory, pro-healing environment that provides a robust soft-tissue seal and prevents the development of peri-implantitis. We anticipate that the creation of this next-generation anti- inflammatory, antibiofilm dental implant system would increase functionality and provide a new strategy to prevent and control peri-implant diseases, especially in populations at risk, and reduce the risk of implant failure.