The use of bioinformatics strategies as a predictive tool in implant-supported oral rehabilitation

It is now known that there are several patient-related factors that seem to influence the bone formation/regeneration process and consequently the osseointegration of dental implants, such as smoking habits, poor oral hygiene, infectious processes, systemic diseases (osteoporosis, diabetes mellitus), and medications that affect bone metabolism. On the other hand, it is not only factors associated with the patient that influence the biological process of osseointegration, and therefore the success of the implant, but also factors related to the surgical stage, prosthetics as well as inherent characteristics of the implant itself, such as wettability, porosity, roughness, are described as influencing the osseointegration process. Today, there are artificial intelligence algorithms capable of providing a powerful diagnostic tool, from the ability to identify dental implants, through radiographic images, to supporting implant prognosis, identifying and even predicting possible clinical conditions such as early bone loss, mucositis or peri-implantitis. Currently, through methodologies based on advanced neural networks - machine learning - it is possible, besides the previous examples, to anticipate the degree of complexity and the potential risk involved in a given rehabilitative case with an implant. However, all scientific evidence as well as the risk tools used today by practitioners are based on clinical and radiographic parameters that provide limited therapeutic guidance due to the multifactorial complexity of implant supported rehabilitation. Moreover, from the point of view of diagnosis and staging of peri-implant diseases, they are methods that document only the pre-existing state and not the current disease, not considering the progression of the clinical picture. Moreover, they do not take into account systemic conditions, lifestyle, hormonal changes, aging, and many other factors associated with inflammatory processes and that consequently influence the local immune response, whether around a tooth - periodontitis - or around a dental implant - peri-implantitis. Ultimately, the "immunophenotype" is considered to play an important role in the severity of oral inflammatory diseases, as individuals are considered to have a hyper-reactive genetic predisposition and therefore overreact to even small amounts of bacterial biofilms. In considering all these facts and recognizing the multifactorial complexity of oral inflammatory pathology, the ability to...