Dental implant material related changes in molecular signatures in peri-implantitis - A systematic review and integrative analysis of omics in-vitro studies

Objective: Since peri-implantitis differs clinically and histopathologically from periodontitis, implant wear debris is considered to play a role in the destructive processes. This work aims to systematically review if titanium particles affect oral-related cells through changes in molecular signatures (e.g., transcriptome, proteome, epigenome), thereby promoting peri-implantitis. Methods: Leveraging three literature databases (Medline, Embase, Cochrane) a systematic search based on a priori defined PICOs was conducted: '-omics' studies examining titanium exposure in oral-related cells. After risk of bias assessments, lists of differentially expressed genes, proteins, and results of functional enrichment analyses were compiled. The significance of overlapping genes across multiple studies was assessed via Monte Carlo simulation and their ranking was verified using rank aggregation. Results: Out of 2104 screened articles we found 12 eligible publications. A significant overlap of gene expression in oral-related cells exposed to titanium particles was found in four studies. Furthermore, changes in biological processes like immune/inflammatory or stress response as well as toll-like receptor (TLR) and mitogen-activated protein kinase (MAPK) signaling pathways were linked to titanium in transcriptome and proteome studies. Epigenetic changes caused by titanium were detected but inconsistent.

Automated summary

This study aims to systematically review the impact of titanium particles on oral-related cells by examining changes in molecular signatures. Through a systematic search, 12 eligible publications were identified, and a significant overlap of gene expression in oral-related cells exposed to titanium particles was found in four studies. Changes in immune/inflammatory and stress response processes, as well as toll-like receptor and mitogen-activated protein kinase signaling pathways, were associated with titanium exposure in transcriptome and proteome studies. However, the findings regarding epigenetic changes caused by titanium were inconsistent.