Do we really understand the etiology of this disease entity called Peri-Implantitis?? It would seem to form around HA coated implants due to what? Where do the microbes come from? Are they the same ones as in periodontitis?
If so how does this disease spread w/o a pdl. Also I was under the impression that Titanium resisted microbe growth by forming some type of "peroxide gel" due to its "bioactive" surface. The plaque is there but not alot of inflamation. Or when there is inflamation I have not associated it with loss of attachment to bone. Calculous forms on root form implants but with a weak attachment. When removed the underlying tissue does not generally seem raw. And how often do you see sub-gingival calculous around dental implants?? The only times I have seen this is with ging.hyperplasia w/o bone loss. This disease entity has me baffled. I am not so sure that the microbes are the primary causitie agent and are secondary to something else that may have more of a mechanical etiology. The microbes are perhaps just secondary in arriving after the initial insult.. ???