Historically, there has been broad consensus that osseointegration represents a homeostasis between a titanium dental implant and the surrounding bone, and that the crestal bone loss characteristic of peri-implantitis is a plaque-induced inflammatory process. However, this notion has been challenged over the past decade by proponents of a theory that considers osseointegration an inflammatory process characterized by a foreign body reaction and peri-implant bone loss as an exacerbation of this inflammatory response. A key difference in these two schools of thought is the perception of the relative importance of dental plaque in the pathogenesis of crestal bone loss around implants, with obvious implications for treatment. This review investigates the evidence for a persistent foreign body reaction at osseointegrated dental implants and its possible role in crestal bone loss characteristic of peri-implantitis. Further, the role of implant-related material release within the surrounding tissue, particularly titanium particles and corrosion by-products, in the establishment and progression in peri-implantitis is explored. While it is acknowledged that these issues require further investigation, the available evidence suggests that osseointegration is a state of homeostasis between the titanium implant and surrounding tissues, with little evidence that a persistent foreign body reaction is responsible for peri-implant bone loss after osseointegration is established. Further, there is a lack of evidence for a unidirectional causative role of corrosion by-products and titanium particles as possible non–plaque related factors in the etiology of peri-implantitis.

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异物反应在种植体周围炎中的作用：证据是什么？

从历史上看，人们普遍认为骨整合代表钛牙种植体与周围骨之间的稳态，而种植体周围炎的牙槽骨骨丢失特征是菌斑引起的炎症过程。然而，这一观点在过去十年中受到了一种理论的支持者的挑战，该理论认为骨整合是一种炎症过程，其特征是异物反应和种植体周围骨丢失是这种炎症反应的加剧。这两个学派的一个关键区别是牙菌斑在种植体周围牙槽嵴骨丢失发病机制中的相对重要性的认识，对治疗有明显的影响。本综述调查了骨整合牙种植体持续异物反应的证据及其在种植体周围炎特征性牙槽嵴骨丢失中的可能作用。此外，还探讨了种植体相关物质在周围组织中的释放，尤其是钛颗粒和腐蚀副产物，在种植体周围炎的形成和发展中的作用。虽然人们承认这些问题需要进一步调查，但现有证据表明，骨结合是钛种植体与周围组织之间的一种稳态状态，几乎没有证据表明持续的异物反应是骨结合后种植体周围骨丢失的原因。已确立的。进一步，