Metal ion-associated inflammatory reactions in patients with dental implants

• Applicant: Dr. Nils Werner
• Subject Area: Dentistry, Oral Surgery
• Term: since 2026
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 582147792

Titanium dental implants have been a proven treatment method for replacing lost teeth for over 50 years. Although they are successful in most cases, around 20% of patients develop peri-implantitis. Peri-implantitis is an inflammatory disease of the tissue surrounding the implant, which can ultimately lead to implant loss. The exact causes of this disease are not yet fully understood. While bacterial plaque (biofilm) is considered the main cause, there is also evidence that released titanium particles and ions may play a role. These can be released due to mechanical abrasion and chemical corrosion, triggering both local and systemic inflammatory reactions. To date, there has been a lack of systematic studies that simultaneously measure titanium concentrations in the body (blood) and in the mouth (saliva) and investigate their relationship with inflammatory markers. This research project examines blood and saliva samples from a subgroup of the 1,570 patients in the King's College London Oral Biobank. The aim is to determine whether titanium release is associated with both local and systemic inflammatory responses. Therefore, four groups are being compared: individuals with peri-implantitis, those with peri-implant mucositis (a milder form of inflammation), those with healthy implants, and those without implants. The samples will be analyzed during a 7-month research stay at King's College London. High-precision mass spectrometry will be used to measure titanium concentrations, while inflammatory markers (Interleukin-6, Interleukin-8, Tumor Necrosis Factor-α) and oxidative stress will be determined using established immunological methods. Statistical analyses will clarify whether elevated titanium levels are associated with stronger inflammatory reactions and whether risk models for early detection can be developed from this. The project aims to clarify whether titanium release contributes to the development and progression of peri-implantitis and whether local and systemic inflammatory processes influence each other. The results could provide insights for improving implant materials, optimising treatment strategies, and assessing individual patient risk. In addition, a better understanding of these mechanisms could help extend the service life of implants, thereby conserving ecological resources by reducing the need for revision surgery.

• DFG Programme: Fellowship
• International Connection: United Kingdom
• Host: Professor Dr. Luigi Nibali