{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T13:55:17Z","timestamp":1791035717459,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82201048"],"award-info":[{"award-number":["82201048"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82601866"],"award-info":[{"award-number":["82601866"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Periodontal Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Peri\u2010implant tissues are more susceptible than gingiva to rapid inflammatory breakdown, but the cellular basis of this vulnerability remains unclear. This study investigated (1) whether clinically healthy peri\u2010implant mucosa already displays an immune landscape distinct from healthy gingiva, and (2) which cellular states and molecular pathways characterize the transition from peri\u2010implant health to peri\u2010implantitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An integrative single\u2010cell RNA\u2010sequencing analysis was performed using clinically healthy pre\u2010loading peri\u2010implant mucosa (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), healthy gingiva (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917), and peri\u2010implantitis tissues (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093). Healthy peri\u2010implant mucosa was first compared with a healthy gingival reference atlas to define the baseline peri\u2010implant immune niche. Disease\u2010associated changes were then examined by comparing healthy peri\u2010implant and peri\u2010implantitis tissues. Key findings were validated in independent tissue cohorts comprising healthy gingiva, clinically healthy peri\u2010implant mucosa, and peri\u2010implantitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096 participants per group) using multiplex immunofluorescence, immunohistochemistry, and reactive oxygen species (ROS) detection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Clinically healthy peri\u2010implant mucosa showed greater immune\u2010cell enrichment than healthy gingiva, most notably within the myeloid compartment. Among myeloid cells, a CXCR2\n                      <jats:sup>+<\/jats:sup>\n                      neutrophil subset exhibited the highest baseline signature for neutrophil extracellular trap (NET) formation, indicating an immune\u2010enriched state with enhanced NET\u2010associated transcriptional potential, despite clinical health. In peri\u2010implantitis, this CXCR2\n                      <jats:sup>+<\/jats:sup>\n                      neutrophil subset expanded further and displayed increased oxidative, chemotactic, and NET\u2010associated programs, supported by tissue validation of MPO, CXCR2, CitH3, and ROS signals. Cell\u2013cell communication analysis nominated fibroblast\u2010derived CXCL signaling as a potential contributor to CXCR2\n                      <jats:sup>+<\/jats:sup>\n                      neutrophil recruitment. NSUN6, an RNA modification enzyme, was enriched in disease\u2010associated CXCR2\n                      <jats:sup>+<\/jats:sup>\n                      neutrophils, and NSUN6 knockdown in neutrophil\u2010like cells attenuated CXCR2\n                      <jats:sup>+<\/jats:sup>\n                      cell enrichment and NET\u2010associated marker expression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Clinically healthy peri\u2010implant mucosa before functional loading is not immunologically equivalent to gingiva, but represents an immune\u2010primed niche that may lower the threshold for inflammatory breakdown. These findings may not be directly generalized to long\u2010term functionally loaded implants. Peri\u2010implantitis is characterized by amplification of an oxidative CXCR2\n                      <jats:sup>+<\/jats:sup>\n                      neutrophil state, with fibroblast\u2010derived CXCL\u2013CXCR2 signaling and NSUN6\u2010associated neutrophil activation emerging as candidate pathways for future diagnostic and therapeutic investigation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jre.70180","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T13:16:32Z","timestamp":1791033392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Why Peri\u2010Implant Tissues Are Susceptible to Inflammatory Breakdown\u2014Single\u2010Cell Transcriptomics Reveals Immune Priming in Clinically Healthy Peri\u2010Implant Mucosa and\n                    <scp>CXCR2<\/scp>\n                    <sup>+<\/sup>\n                    Neutrophil Activation in Peri\u2010Implantitis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5951-5575","authenticated-orcid":false,"given":"Yi\u2010Rao","family":"Lai","sequence":"first","affiliation":[{"name":"Shanghai Key Laboratory of Stomatology, Department of Implant Dentistry Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases  Shanghai China"},{"name":"Department of Oral Implantology, Tianjin Stomatological Hospital, School of Medicine Nankai University  Tianjin China"},{"name":"Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction &amp; Stomatology Institute of Nankai University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7699-6578","authenticated-orcid":false,"given":"Jia\u2010Ji","family":"Mo","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Stomatology, Department of Implant Dentistry Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin\u2010Xin","family":"Ding","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Stomatology, Department of Implant Dentistry Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui\u2010Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Stomatology, Department of Implant Dentistry Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7067-7044","authenticated-orcid":false,"given":"Xiao\u2010Lei","family":"Lv","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Stomatology, Department of Implant Dentistry Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5646-083X","authenticated-orcid":false,"given":"Mario","family":"Romandini","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Stomatology, Department of Implant Dentistry Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6922-2918","authenticated-orcid":false,"given":"Hong\u2010Chang","family":"Lai","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Stomatology, Department of Implant Dentistry Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9276-3819","authenticated-orcid":false,"given":"Shu\u2010Jiao","family":"Qian","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Stomatology, Department of Implant Dentistry Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"issue":"1","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1177\/0022034515608832","article-title":"Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of 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A Randomized Controlled Trial","volume":"34","author":"Heitz\u2010Mayfield L. J. A.","year":"2023","journal-title":"Clinical Oral Implants Research"},{"issue":"12","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1111\/jcpe.13713","article-title":"Effect of Sub\u2010Marginal Instrumentation Before Surgical Treatment of Peri\u2010Implantitis: A Multi\u2010Centre Randomized Clinical Trial","volume":"49","author":"Romandini M.","year":"2022","journal-title":"Journal of Clinical Periodontology"},{"issue":"3","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/clr.14228","article-title":"Long\u2010Term Outcomes and Prognostic Factors of Surgical Treatment of Peri\u2010Implantitis \u2010 A Retrospective Study","volume":"35","author":"Romandini M.","year":"2024","journal-title":"Clinical Oral Implants Research"},{"issue":"20","key":"e_1_2_13_11_1","first-page":"S230","article-title":"Peri\u2010Implant Health","volume":"45","author":"Araujo M. G.","year":"2018","journal-title":"Journal of Clinical Periodontology"},{"issue":"3","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1111\/clr.14391","article-title":"Influence of Implant Component Materials on Peri\u2010Implant Soft Tissue Healing: A Comparative Histological and Immunohistochemical Study in Humans","volume":"36","author":"Liegeois L.","year":"2025","journal-title":"Clinical Oral Implants Research"},{"key":"e_1_2_13_13_1","article-title":"Soft\u2010Tissue Integration of Dental Implants: Formation, Maintenance, and Relevance for Peri\u2010Implant Health","author":"Aellos F.","year":"2026","journal-title":"Journal of Periodontal Research"},{"issue":"11","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1111\/clr.14153","article-title":"Microbiota Associated With Peri\u2010Implantitis\u2010A Systematic Review With Meta\u2010Analyses","volume":"34","author":"Carvalho \u00c9. B. S.","year":"2023","journal-title":"Clinical Oral Implants Research"},{"issue":"9","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1111\/clr.14124","article-title":"Prevention of Internal Bacterial Colonization of Dental Implants: A Comparative Longitudinal Observational Study","volume":"34","author":"Jerv\u00f8e\u2010Storm P. M.","year":"2023","journal-title":"Clinical Oral Implants Research"},{"issue":"5","key":"e_1_2_13_16_1","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1177\/00220345241307939","article-title":"Microbial Dysbiosis, Titanium Release, and Peri\u2010Implantitis","volume":"104","author":"Kotsakis G. A.","year":"2025","journal-title":"Journal of Dental Research"},{"issue":"2","key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/jcpe.13912","article-title":"Single\u2010Cell Sequencing Identifies Inflammation\u2010Promoting Fibroblast\u2010Neutrophil Interaction in Peri\u2010Implantitis","volume":"51","author":"Mo J. J.","year":"2024","journal-title":"Journal of Clinical Periodontology"},{"key":"e_1_2_13_18_1","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2021.711337","article-title":"Single\u2010Cell RNA Sequencing Identifies New Inflammation\u2010Promoting Cell Subsets in Asian Patients With Chronic Periodontitis","volume":"12","author":"Qian S. 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H.","year":"2022","journal-title":"Journal of Translational Medicine"},{"issue":"2","key":"e_1_2_13_29_1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/jre.13422","article-title":"Peri\u2010Implantitis and Soft Tissue Dehiscence in a Turkish Population: Risk Indicators, Diagnostic Parameters and Biomarkers Discovery","volume":"61","author":"Isler S. C.","year":"2026","journal-title":"Journal of Periodontal Research"},{"issue":"12","key":"e_1_2_13_30_1","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1111\/jre.70018","article-title":"Role of Keratinized Mucosa on the Risk of Peri\u2010Implant Diseases and Soft Tissue Dehiscence in the Posterior Mandible\u2010A 20\u2010Year Prospective Cohort Study","volume":"60","author":"Roccuzzo A.","year":"2025","journal-title":"Journal of Periodontal Research"},{"issue":"12","key":"e_1_2_13_31_1","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1111\/jre.13367","article-title":"Incidence and Risk Factors of Peri\u2010Implantitis Over Time\u2010A Prospective Cohort Study","volume":"60","author":"Romandini M.","year":"2025","journal-title":"Journal of Periodontal Research"},{"issue":"11","key":"e_1_2_13_32_1","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1177\/0022034514551754","article-title":"Composition of Human Peri\u2010Implantitis and Periodontitis Lesions","volume":"93","author":"Carcuac O.","year":"2014","journal-title":"Journal of Dental Research"},{"issue":"12","key":"e_1_2_13_33_1","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1111\/jcpe.13370","article-title":"Cellular Expression of DNA Damage\/Repair and Reactive Oxygen\/Nitrogen Species in Human Periodontitis and Peri\u2010Implantitis Lesions","volume":"47","author":"Dionigi C.","year":"2020","journal-title":"Journal of Clinical Periodontology"},{"issue":"8002","key":"e_1_2_13_34_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/s41586-024-07056-1","article-title":"Structure of Human Phagocyte NADPH Oxidase in the Activated State","volume":"627","author":"Liu X.","year":"2024","journal-title":"Nature"},{"issue":"1","key":"e_1_2_13_35_1","doi-asserted-by":"crossref","first-page":"6079","DOI":"10.1038\/s41467-022-33711-0","article-title":"Structure of the Core Human NADPH Oxidase NOX2","volume":"13","author":"Noreng S.","year":"2022","journal-title":"Nature Communications"},{"issue":"1","key":"e_1_2_13_36_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1038\/s41392-024-01933-x","article-title":"Neutrophil Extracellular Traps in Homeostasis and Disease","volume":"9","author":"Wang H.","year":"2024","journal-title":"Signal Transduction and Targeted Therapy"},{"issue":"1","key":"e_1_2_13_37_1","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1177\/00220345251360752","article-title":"Periodontitis Leads to Systemic Bone Loss Through Neutrophil Reprogramming","volume":"105","author":"Martin K.","year":"2026","journal-title":"Journal of Dental Research"},{"issue":"3","key":"e_1_2_13_38_1","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/cid.13325","article-title":"Detection and Comparison of Neutrophil Extracellular Traps in Tissue Samples of Peri\u2010Implantitis, Periodontitis, and Healthy Patients: A Pilot Study","volume":"26","author":"Al\u2010Bakri S. 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