Infections associated with dental implants may cause peri-implantitis often resulting in implant loss and impaired function. According to recent studies, the incidence of peri-implantitis is between 10% and 50%. There are many factors that may play a role in the emergence of peri-implantitis but its etiology is still not known. Research suggest that the peri-implantitis is a polymicrobial infection triggered by both aerobic and anaerobic bacteria making complete recovery very hard to achieve, even after the combination of surgical decontamination and antibiotic therapy.
During the last couple decades many biomaterials have been developed as potential implant materials empowered by high biocompatibility. A lot of distinguished scientific achievements have been translated into implant products, however, the improved biocompatibility of implant materials with human tissues entails their increased susceptibility for bacterial infections, as well. Due to the spreading antimicrobial resistance of bacteria biofilm formation poses severe threat to the survival of any titanium implants once they have been contaminated with pathogenic bacteria. The current dental implants have micro pits and furrows on their titanium-dioxide surface because these structures are believed to support the attachment of osteogenic cells that play pivotal role in bone tissue formation around the implant. Unfortunately, these microstructures also facilitate the attachment of bacteria on the implant surface. Contrarily, based on some research groups’ preliminary findings, the increased surface roughness on titanium implant materials in nano-range may result antibacterial property without any toxic effect on osteogenic cells. A possible explanation is that the superficial nanostructures facilitate the release of free radicals that are responsible for the antibacterial effect.