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. 2025 Mar 18;5:78. doi: 10.1038/s43856-025-00756-3

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© The Author(s) 2025

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 4 — a Representative Hematoxylin & Eosin micrographs in one peri-implantitis and one reference implant specimen. The implant/tissue interface is found on the right side of the samples. Magnification 20×. Scale bars: 1 mm. b Distribution of diameter and circularity values of titanium particles in peri-implantitis (n = 1228) and reference implant (n = 663) sites. K-densities represented by red continuous lines. c Representative images of titanium micro-particles depending on size and shape. d Heatmaps illustrating the distribution of titanium micro-particles based on results from linear measurements in peri-implantitis and reference implant specimens. e Heatmaps representing the distribution of small and large particles based on results from linear measurements in peri-implantitis and reference implant specimens (peri-implantitis: small particles n = 755, large particles n = 473; reference implants: small particles n = 41, large particles n = 251). f Violin plots representing the distribution of small and large particles based on results from linear measurements in peri-implantitis and reference implant specimens. *p < 0.0001, Mann-Whitney U test. g Representative TEM images illustrating sections from peri-implantitis and reference implant specimens. Red arrows indicate metal-like particles. Magnification: 1600× & 6700×.