If the the bone is exposed to the outer environment. Bone loss is tend to occur...to minimise it we can advise anti-inflammatory drugs preoperativly, decrease the duration of exposed bone we can also place bone grafts.

Decrease the immue response when bone cells touch the fixture surface. Therefore, fixture surface treatment is very important. Wettability tendency is better at hydrophobic, or hydrophilic? I wrote my thesis which just be finished the result part and posted to school website just discussed this question.

I believe that it would not be possible because if we blocked the proinflammatory factors there would be no inflammatory process and therefore there would be no repair of the peri-implant tissues. I believe that the important thing would be to accelerate the process of tissue repair. The cause of peri-implant bone tissue loss progressively has 2 possible explanations; one is microbiological (microorganisms enter between the implant platform and the prosthetic abutment) and the other is biomechanics (as the implant has function and since it does not have a periodontal ligament occlusal forces tend to produce greater pressure in the bone and therefore loss of bone).

I agree with this statement...in addition to this..if we can decrease inflammatory reactions which are caused by multi factorial situations like poor oral health, good underlying medical status and good nutritional conditions. One of the treatments modality to overcome the periimplantitis conditions are low level laser therapy...it is an effective way for this case.

Dear Dr. Sarmad Al-Sahaf ,

even though this is an interesting point of view, I think that pro-inflammatory factors are a very small piece of the puzzle.

Sometimes wrong implant placement can result in bone dehiscences, as a result of natural post-extractive bone resorption. But almost always, peri-implant bone loss occurs as a result of either the bacterial infection or the establishment of the soft tissue attachment around the implant. Specifically, about the latter, we assume that the soft tissue attachment has some specific dimensions, and in order for it to be accommodated, bone resorption occurs.

The effect of excessive occlusal loading on peri-implant bone is not really of concern in the clinical context (Heitz-Mayfield et al. 2004). Excessive loading is however associated with more technical complications.

In that context, there are other important factors with a more significant impact, that we can address clinically in order to minimize peri-implant bone loss. Dr Tomas Linkevicius has done some amazing work on this field and I would highly suggest anyone who is interested in Implant Dentistry to study his work.

Hope this helps!