Detection of submicron titanium debris associated with peri-implantitis

Objective The main aim of this study was to perform a systematic review on the detection of submicron-scale titanium debris at peri-implant tissues focusing on the analytical methods. Methods A PRISMA-oriented systematic search was carried out on PubMed and Scopus using the following search items: titanium debris, submicron particles, peri-implantitis, analytical methods, inflammation, and implant failure. The inclusion criteria involved in vivo studies published in the English language, until November 26, 2025. Risk of bias was assessed using the ROBINS-I tool. Results Previous studies reveal submicron-scale titanium debris at peri-implant tissues although the particles' detection depend on the microscopic method. High-resolution SEM and TEM images clearly showed titanium debris’ dimensions below 1 µm although the heterogeneity of the studies revealed limitations on the particles’ measurements. Some titanium particles were associated with oxidative stress and activation of pro-inflammatory cytokines to osteoclastogenesis (i.e., RANKL/RANK/OPG) and other inflammatory mediators such as IL-1β, IL-6, TNF-α, PGE2. Conclusion Thus, submicron titanium debris can be detected at peri-implant tissues that indicate the degradation of the materials and potential adverse biological effects in the human body. However, the analytical methods should involve high-resolution microscopy and a careful analysis of the images. Graphical abstract