Titanium micro-particles are commonly found in soft tissues surrounding dental implants

Carlotta Dionigi; Gyula Nagy; Jan Derks; Yuki Ichioka; Cristiano Tomasi; Lena Larsson; Daniel Primetzhofer; Tord Berglundh

doi:10.1038/s43856-025-00756-3

Titanium micro-particles are commonly found in soft tissues surrounding dental implants

Commun Med (Lond). 2025 Mar 18;5(1):78. doi: 10.1038/s43856-025-00756-3.

Authors

Carlotta Dionigi¹, Gyula Nagy², Jan Derks^{1

3}, Yuki Ichioka¹, Cristiano Tomasi¹, Lena Larsson¹, Daniel Primetzhofer^{2

4}, Tord Berglundh^{5

6}

Affiliations

¹ Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
² Department of Physics and Astronomy, Uppsala University, Uppsala, Sweden.
³ Clinic of Periodontics, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.
⁴ Tandem Laboratory, Uppsala University, Uppsala, Sweden.
⁵ Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. tord.berglundh@odontologi.gu.se.
⁶ Clinic of Periodontics, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden. tord.berglundh@odontologi.gu.se.

Abstract

Background: Dental implants are one of the most frequently used medical devices for therapeutic purposes in dentistry. Peri-implantitis is a severe, microbial biofilm-associated condition, characterized by inflammation in peri-implant soft tissues and destruction of supporting bone. It has been suggested that metal particles originating from the implant may influence the local host response to microbial biofilms.

Methods: Soft tissue biopsies were collected from implant sites with and without peri-implantitis in 21 patients. Micro Proton-induced X-ray Emission (µ-PIXE) analysis was used to localize, quantify and characterize titanium micro-particles within tissues. RNA sequencing was performed to evaluate potential associations between titanium micro-particles and gene expression profiles in peri-implantitis lesions.

Results: Titanium micro-particles are consistent findings in soft tissues surrounding dental implants. Their occurrence varies across patients but not between sites with and without peri-implantitis within the same individual. Most particles reside in a 2-mm wide tissue portion close to the implant/tissue interface. The time in function of the implants does not influence the volumetric density of titanium micro-particles, while implant systems do. Fourteen differentially expressed genes are identified when comparing peri-implantitis samples with high and low densities of titanium micro-particles. The gene-set enrichment analysis reveals functions related to the regulation of the immune response and epithelial development.

Conclusions: The present results indicate that titanium micro-particles are commonly found in tissues surrounding dental implants and are not associated with the occurrence of peri-implantitis.

Plain language summary

Dental implants are frequently used in dentistry. Peri-implantitis is a severe condition in which micro-organisms such as bacteria grow excessively and cause inflammation in areas around the implants. This can result in destruction of supporting bone. It has been suggested that metal particles originating from the implant may influence how the body reacts to the presence of the bacteria. We analyzed samples of human soft tissue taken from implant sites with and without peri-implantitis. Titanium micro-particles were consistent findings in the soft tissue specimens regardless of the presence of peri-implantitis. The results indicate that titanium micro-particles are commonly found in tissues surrounding dental implants and are not associated with the occurrence of peri-implantitis.