Balancing Biology and Technology in Implant Dentistry

24 February 2025

Human teeth have a limited capacity to regenerate, whilst the biological reconstruction of damaged dental tissues is a challenge for dentists[i]. A dental implant answers both of these problems and sits in the crosshairs of biology and technology; it is a well-designed artifice that mimics the natural dentition.

Whilst technology continues to develop and innovate in its pursuit for outstanding implant outcomes, biology has a much older set of rules that must be adhered to for the long-lasting results that patients want. Technology versus biology represents a balancing act that all implant clinicians must navigate in their daily workflow.

 

The role of genetics

DNA affects an implant in numerous ways – in an edentulous study group that all received an implant treatment, biological complications were reported in 13.5% of patients.[ii] Each patient has a unique genetic code, bringing with it varying degrees of risk for inherited health conditions or different reactions to medicines or treatments.[iii] A patient’s susceptibility to a disease is therefore connected to their gene expression and function; polymorphisms within certain genes are associated with pathologies that can trigger peri-implant diseases.[iv] This includes peri-implantitis, which is also associated with age, history of periodontal disease, and the number of missing teeth a patient has.ⁱⁱ

Inherited factors can also contribute to the failure of osseointegration, with a limited immune system regulation on bone metabolism and bone density affecting the implant’s survival.^iv If pathogens are present in the oral cavity, the cytokines and chemokines used in the healing process can be altered depending on a patient’s genetics. Around the implant site, this alteration can cause inflammation, swelling the area with mediators like interleukins – these can induce bone resorption or stimulate bone formation.^iv As such, a patient’s innate biology can determine the success of an implant, a challenge that technology may struggle to overcome.

 

What the patient can control

Whilst inherited factors are concrete, there are many other biological factors that patients can control to prevent implant failure. One of these is diet, with an intake of nutrient dense foods ensuring superior bodily health. Nutritional deficiencies can limit the chance of osseointegration, with vitamin D being essential for bone health. By regulating calcium and phosphate metabolism, vitamin D enhances the healing process and maintains bone density.[v] To achieve optimal vitamin D levels for successful osseointegration, implant patients with a deficiency can consume more fish, red meat, egg yolks and breakfast cereals, as well as dietary supplements, before and after implant treatment.[vi]

The oral cavity is constantly exposed to chemical, mechanical and bacterial forces which means it is a challenging environment for healing to occur. One of the impacts of diabetes, a condition that can also be inherited, is delayed wound healing, caused by improper blood perfusion and damaged vasculature.[vii] Impaired healing can lead to a lack of irrigation, overheating and micromotion, causing bacterial infection. To prevent tooth loss and reduce the risk of diabetes, cutting down on ultra-processed foods and prioritising whole grains, fatty fish, fruit and leafy greens is recommended to keep the teeth and gingivae protected from pathogens.[viii]

 

Technological triumphs

As research continues to reveal new insights into the relationship between biology and implant treatments, advances in areas like digital planning, optimised intraoral scanning and guided surgery have transformed the way cases are approached, overcoming challenges and reducing chair time for patients. For dentists, harnessing surgical techniques that maximise bone-implant contact can improve osseointegration success, especially for patients with a low bone density, reducing the risk of implant failure in its first year.^iv

As our understanding of biology continues to grow, harnessing the right technologies, techniques and materials to adapt to new research best ensures that patients receive long-lasting implants.

 

Share in the latest knowledge

To learn the latest biological and technological breakthroughs within the implant world, attend the ADI Team Congress 2025. The diverse spread of educational lectures covers topics such as nutrition and lifestyle considerations for implant patients, the key biological factors for implant success in the aesthetic zone, and the importance of computer-aided planning and diagnostics. The action-packed timetable promises a spectacle of information, networking and skill progression, providing dental professionals with up-to-date intel on the latest developments. Head down to Brighton for the ADI Team Congress 2025 on 1-3^rd May – you won’t want to miss it.

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