New research indicates that implant failure might not always derive from surgical complications or defects in material, but, instead, from the body’s immune response becoming dysregulated.
A study from the Faculty of Dentistry at Dalhousie University in Canada recently explored how the immune system can mistakenly endure an inflammatory reaction around medical implants, which includes dental. The response may then persevere, and, rather than healing, it can compromise the current and continuous stability of the implant.
Study leader Neal Callaghan, a research assistant in the Davenport Huyer Lab and an internal medicine resident physician, explained, “implantable devices are everywhere. But in some patients, these devices cause chronic inflammation – not because of the surgery or the device itself, but because of how the immune system reacts.”
As mentioned by Dentistry, the findings revolve around the metabolic process known as glycolysis, which is normally associated with cellular activity in small bursts. This allows glycolysis to appear to remain active in immune cells surrounding implants, preventing them from returning to resting state.
To understand this more clearly, the study compared immune cell behaviour to athletic performance. Co-leader Christian Rempe, a PhD student in microbiology and immunology, states that “different activities need different kinds of energy. A sprinter and a marathoner don’t fuel the same way. Immune cells are similar, but in chronic inflammation, they get stuck using the wrong energy system.”
In normal conditions, the body initially begins a ‘sprint’ response following implant placement, before transitioning into a steady ‘marathon’ phase as healing progresses. However, when immune cells are stuck in the high energy mode, they continue to react like a threat is still present. Over time, this can cause discomfort, structural changes, and ultimately implant failure.
Dr Callaghan explored the potential impact of this work, clinically, “if we can pinpoint the exact immune pathways involved, we can prevent tens of thousands of patients every year from needing painful revision surgeries.”
He concluded, “my biggest goal in medicine is to help more patients. That means understanding disease at its roots, questioning what we assume we already know, and finding the gaps where innovation can happen.”
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