Cutting-edge research on treating chronic inflammatory disease (peri-implantitis) post dental implants

Dr. Asaf Wilensky, D.M.D., Ph.D.

Dental implants provide a common and very expensive treatment option to replace missing teeth to restore both functionality and aesthetics. It is estimated that over 500,000 implants are currently placed per year in the U.S. only and many more around the world. However, about 20-50% of people who had implants for five to ten years experience peri-implantitis, a chronic inflammatory disease that destroys soft and hard tissues around the implant causing implant and restoration failure. This condition has been described by leading dental surgeons as a ‘time bomb.’ This disease generally occurs without the patient being aware of it since it generally progresses in a painless fashion. Peri-implantitis and its causes are still poorly understood and presently, there is no gold standard approach for its treatment.

The current hypothesis claims that the bacteria around the crowns and implants (dental plaque) is the main cause of peri-implantitis; however the destruction is caused by an excessive body’s immune response to the dental plaque. Despite substantial evidence that tissue destruction is due to excessive inflammation, the current approach to prevention and treatment of peri-implantitis is to remove plaque, rather than treat the inflammation. Plaque removal is flawed since peri-implantitis cannot be cured with plaque control. This approach results in loss of tissue and compromised esthetics.

In light of these problems and due to the continuously increasing number of implants placed in everyday dental practice, we reasonably expect an increasing prevalence of peri-implantitis and the necessity for an effective treatment. Dr. Asaf Wilensky from the School of Dentistry at Hadassah University Hospital is undertaking a very important research with the premise that resolution of inflammation is an active process rather than a passive decay of pro-inflammatory signals. He is encouraged by the potential of pro-resolving molecules such as Resolvin D2 to promote the resolution of inflammation, thus preventing periodontal (gum disease) pathology around implants and teeth. Dr. Wilensky used an animal model for this research and found the encouraging result that simple topical applications of Resolvin D2 actually terminated inflammation and bone loss and thus prevented periodontal disease. This finding is really unprecedented in periodontal therapy.

Dr. Wilensky’s proposed work is to gain an understanding on how the bacteria-induced peri-implantitis develops and to determine the mechanism by which Resolvin D2 prevents and treats this phenomenon for the overall health of patients. Dr. Wilensky has successfully developed a novel mouse model of peri-implantitis with the aim of finding innovative treatment. The use of a small animal model for periodontal disease and peri-implantitis has many advantages: 1) a small animal model is less expensive and thus allowing to study complex immune mechanisms which cannot be studied in large animals 2) this model generates important and relevant information on the potential mechanisms involved in inflammation in the soft and hard tissues during periodontal disease and peri-implantitis; 3) the use of genetically manipulated animals allows us to study the involvement of specific genes in periodontal and peri-implant diseases. Dr. Wilensky’s research will produce important information for the resolution and healing processes in gum disease and peri-implantitis, thus the potential of improving the global quality of life and overall health outcomes in post-implant and periodontal patients.

Support for the research undertaken by Dr. Wilensky is of the utmost importance due to the increasing prevalence of peri-implantitis and the significant problem it poses given the cumulative number of implants delivered over time. His research plan aims to produce a simple and effective treatment that will have great impact not only on those millions of individuals throughout the world who suffer from untreatable post-implant diseases but also awareness of an effective treatment on those planning to have teeth implanted.