Haim Tal

By Haim Tal, Ofer Moses, Avital Kozlovsky and Carlos Nemcovsky

Part of the book: Bone Regeneration

By Haim Tal, Zvi Artzi, Roni Kolerman, Ilan Beitlitum and Gal Goshen

Part of the book: Bone Regeneration

By Haim Tal

Part of the book: Bone Regeneration

By Liat Chaushu, Gavriel Chaushu and Haim Tal

Peri-implantitis is one of the most challenging biological complications in contemporary implant dentistry. It is characterized by peri-implant mucosal inflammation and progressive bone loss that may ultimately lead to implant failure. The condition represents a multifactorial breakdown of host-implant homeostasis, influenced by microbial biofilms, host immune dysregulation, and biomechanical factors. Despite significant progress in preventive strategies and surface decontamination techniques, achieving a long-term resolution of peri-implantitis and predictable re-osseointegration remains challenging. This chapter provides a comprehensive overview of the current understanding of peri-implantitis, spanning its pathophysiology, diagnostic principles, and therapeutic approaches. It critically evaluates both conventional treatment modalities—mechanical and chemical debridement, antimicrobial protocols, laser and photodynamic therapy, and regenerative interventions. Particular attention is given to novel implant-surface renewal strategies, which may enable minimally invasive, prosthesis-preserving management of advanced peri-implantitis. In addition, the chapter examines the evolving role of systemic and molecular biomarkers in disease monitoring and precision risk assessment. By integrating current clinical evidence with experimental advances, this chapter outlines the transition of peri-implantitis management from conventional decontamination toward regenerative, biomarker-guided, and implant-design-driven paradigms, offering a forward-looking perspective on the future of personalized peri-implant therapy.

Part of the book: Periodontics and Implants

By Evgeny Weinberg and Haim Tal

Oral mucosal keratinization is a finely regulated biological process essential for maintaining masticatory function, barrier integrity, and periodontal stability. This comprehensive review traces the evolution of our understanding of oral epithelial phenotype determination, from pioneering transplantation studies conducted in the 1970s that established the stromal connective tissue as the key determinant of epithelial fate, to recent molecular and transcriptomic discoveries. Modern research reveals that extracellular matrix components, basement membrane proteins such as COL4A6 and COL18A1, and soluble mediators including TGFβ-binding proteins, retinoic acid, and BMP2 orchestrate keratinization through dynamic epithelial-stromal interactions. Single-cell and bulk transcriptomic analyses further uncover cellular heterogeneity within gingival and lining mucosa, highlighting mesenchymal stem cell-rich niches in keratinized tissues. Clinically, these insights redefine strategies for managing soft-tissue deficiencies around teeth and implants, emphasizing biologically guided rather than purely surgical approaches. Emerging spatial transcriptomic technologies now enable high-resolution mapping of gene expression within intact oral tissues, bridging histology and molecular biology. Together, these advances lay the groundwork for next-generation regenerative therapies aimed at inducing keratinized mucosa through the targeted modulation of stromal signaling networks and epithelial differentiation pathways.

Part of the book: Periodontics and Implants