Harnessing osteoimmunity to treat peri-implant inflammatory osteolysis

Abstract

Osteoimmunity is an interactive schema by which organisms maintain bone homeostasis. It permeates bone remodeling in healthy or diseased states, such as osseointegration of an oral implant material–alveolar bone socket or inflammatory osteolysis at the plaque-oral tissue–implant material interface. Once the self-mobilized osteoimmune system is insufficient to resist the spread of infection or inflammation caused by progressive periodontitis, smoking, or diabetes, peri-implant bone homeostasis will be tilted toward inflammatory osteolysis, as evidenced by an inflammatory response, osteoblast suppression, and osteoclast hyperactivity. Therefore, in addition to etiological treatment, harnessing osteoimmunity to enhance bone homeostasis stability and tissue anti-inflammatory capacity has also become a therapeutic approach for peri-implantitis. Here, we extract therapeutic targets in terms of cellular, protein, epigenetic modification, ribonucleic acid (RNA), and podosome-related osteoimmune mechanisms in inflammatory osteolysis, summarize the existing bioactive materials, implant surface modification, extracellular vesicles and other bioengineering techniques using osteoimmunity in the treatment of inflammatory bone loss, and look at potential targets for harnessing osteoimmunotherapy in peri-implantitis.