Fig. 1.

Hypothetical scenario: Functional dental implant and eventual accumulation of antigens (ions, nano and microparticles and bacterial antigens) with the presence of activated immunological sentinels (DCs and macrophages) throughout the implant-tissue interface. If the inflammation is not resolved or reactive due to the stress signals and the immunogenicity of the elements present, there is a risk that initially relatively harmless peri-implant bone loss progresses to a more damaging and vicious stage, due to the polarization capacity of the MNGC. Ag = antigen; DC = dendritic cell; F = fibroblast; HBMMSC = human mesenchymal stem cells derived from bone marrow; L = lymphocyte; M1 = macrophage; MNGCs = multinucleated giant cells; Ob = osteoblast; Oc = osteoclast; Ost = osteocyte.