This narrative review proposes that implant and abutment nanotopography can simultaneously influence epithelial and fibroblast attachment, extracellular matrix, microbial retention, macrophages and neutrophils, and osteocyte networks that shape peri-implant tissue stability.
Key findings
- Peri-implant breakdown reflects disrupted soft-tissue sealing, biofilm invasion, foreign-body stimuli, and dysregulated innate immunity. Nanotopography acts through mechanotransduction in a design-dependent manner. Anisotropic nanospikes and biomolecule delivery are future directions, not current standards.
Why this matters globally
Peri-implantitis is a major complication, and region-specific designs may outperform one surface everywhere, emphasizing soft-tissue sealing at abutments and bone integration apically. Manufacturability, durability, cleanability, and long-term outcomes remain to be proven.
Thai researcher contribution
Authors affiliated with Chulalongkorn University's dental stem-cell center and Tohoku University integrated materials science, immunology, and implant dentistry.
Limitations to consider
Narrative selection and lack of formal risk-of-bias appraisal limit certainty. In vitro and animal conditions differ from the human mouth, and chemistry often changes with topography, confounding attribution. Direct evidence that any surface prevents long-term peri-implantitis is insufficient.