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Research over four decades has established implant wear as the main culprit for chronic inflammation in the peri\u2010implant tissues and macrophages as the key cells mediating the host reaction to implant\u2010derived wear particles. Wear debris activated macrophages secrete inflammatory mediators that stimulate bone resorbing osteoclasts; thus bone loss in the peri\u2010implant tissues is increased. However, the balance of bone turnover is not only dictated by osteoclast\u2010mediated bone resorption but also by the formation of new bone by osteoblasts; under physiological conditions these two processes are tightly coupled. Increasing interest has been placed on the effects of wear debris on the cells of the bone\u2010forming lineage. These cells are derived primarily from multipotent mesenchymal stem cells (MSCs) residing in bone marrow and the walls of the microvasculature. 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