Dental Luting Cements and Peri-Implantitis: Molecular Mechanisms, Clinical Implications and the Role of Autophagy and Nanotechnology-A Narrative Review.

Background and

Objectives

This narrative review aims to evaluate the correlation between dental luting cements, peri-implantitis and the molecular mechanisms governing tissue destruction, with a specific focus on the role of autophagy and nanotechnology.

Methods

A comprehensive literature search was conducted across electronic databases, including PubMed, Scopus and Web of Science, to identify relevant studies on cement cytotoxicity, cellular responses and nanomaterial integration.

Results

Residual cement in the peri-implant sulcus promotes biofilm accumulation and severe inflammation. At a cellular level, resin-base monomers (e.g., Bis-GMA) impair human gingival fibroblasts via oxidative stress and mitochondrial dysfunction. Autophagy serves as a vital cytoprotective mechanism against cement toxicity and titanium particle accumulation. Experimental studies suggest that incorporating nanomaterials, specifically graphene oxide and silver nanoparticles (≤1 wt.%), has shown promising results in enhancing antimicrobial efficacy without compromising biocompatibility in vitro.

Conclusions

To minimize peri-implantitis, clinical protocols should prioritize the meticulous removal of excess cement and the development of nano-reinforced luting agents. Optimizing these molecular pathways offers actionable preventive strategies, guiding clinicians toward safer cementation protocols and enhanced long-term implant success.