I recently had a case of recurring peri-implantitis after I successfully treated it, in a patient’s mouth that has perfect home care. I noted corrosion by-products on the soft tissue around #6. Until I heard the variety of contents in dental implants this would have confused me. Silva et al (J Oral Implantology, 2021 )studied the corrosion products from gold based UCLA abutments, which my referring Dr’s used exclusively until CAD/CAM Ti milled abutments became popular. He found the Tibocorrosion of the Ti implants coupled with Gold based abutments resulted in fretting particles, pitting, and crevice corrosion. So the more the abutment moves in the implant the more breakdown products. Today, I got the material safety data sheet from Nobel and their implants contain 2% iron. If memory serves me right…that rusts! I suspect that we will see more of that corrosion as CAD/CAM abutments include other metals, which with saliva sets up a battery effect. So this case was a cuspid implant splinted to a second bicuspid. The cuspid moves anteriorly (protrusive) and laterally (excursion) while the bicuspid moves inferior/superiorly. Hence the degradation. Needless to say, I am using more Zirconium implants as time goes on.
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