Regulatory T Cells in Peri-implant Diseases: Current Osteoimmunologic Perspectives and Translational Challenges.

Abstract

Background: Peri-implantitis has become an increasingly important clinical challenge with the growing number of patients receiving dental implants worldwide. Previous peri-implant research has predominantly focused on surgical factors, including implant position, angulation, and design, as well as biofilm-associated infection. In contrast, relatively less attention has been given to host immune regulation. Recent advances in osteoimmunology have highlighted thepotential role of regulatory T cells (Tregs) in infl ammatory control and tissue homeostasis.

Methods: This review examines current evidence regarding immune-cell regulation in peri-implant diseases from an osteoimmune perspective. Particular attention is given to the interactions between primary immune cells, especially macrophages, and secondary immune cells, particularly Tregs, as well as their potential roles in peri-implant inflammation and bone responses.

Results: Accumulating evidence suggests that bone responses around dental implants are infl uenced by osteoimmune mechanisms. Tregs have emerged as important regulators of infl ammatory processes and may contribute to themaintenance of peri-implant tissue homeostasis. Furthermore, complex interactions between macrophages and Tregs appear to influence local immune conditions surrounding implants. Current studies indicate that osteoimmune regulation may provide additional insights into the pathophysiology of peri-implant diseases and reveal potential targets for immunomodulatory intervention. However, biological limitations and signifi cant knowledge gaps remain regarding the precise role of Tregs in peri-implantitis.

Conclusion: An osteoimmune perspective may broaden the current understanding of peri-implant diseases beyond traditional surgical and microbiological paradigms. Treg-mediated immune regulation represents a promising area for future investigation, with potential translational implications for the prevention and management of peri-implantitis.