Microencapsulated phytomedicines: a localized therapeutic strategy for peri-implantitis

Since Per Ingvar Brånemark's groundbreaking establishment of osseointegration in 1965, dental implants have revolutionized oral rehabilitation; however, their anatomical vulnerability to bacterial contamination has led to peri-implantitis affecting up to 20% of patients within 10 years, necessitating treatment approaches ranging from non-surgical debridement to surgical intervention. Given the limitations of conventional allopathic therapies, this review aims to: (1) contrast periodontitis evidence with peri-implantitis data; (2) identify knowledge gaps in pathophysiology, microbiota, and therapeutic response; (3) detail microencapsulation technologies for local delivery; and (4) propose a regulatory roadmap for clinical translation of phytomedicines. The review was conducted by compiling data from PubMed, Scielo, Scopus, and Web of Science using the keywords "peri-implantitis," "microencapsulation," "herbal medicines," and "local delivery systems." Peri-implantitis remains a complex challenge without a definitive treatment protocol, often presenting greater severity than periodontitis due to anatomical factors and biofilm composition. Phytotherapy offers promising anti-inflammatory and antimicrobial compounds, though its clinical application is limited by stability and bioavailability issues inherent to systemic therapies. Microencapsulation technology addresses these limitations by enabling controlled, localized drug delivery directly to peri-implant pockets. This approach enhances therapeutic efficacy while reducing systemic side effects, costs, and the risk of antimicrobial resistance. By integrating phytotherapeutic agents with microencapsulation techniques, two strategic pathways emerge: developing antibacterial implant coatings and promoting bioactive molecules for tissue regeneration. The final structure contrasts evidence from periodontitis with the limited data on peri-implantitis, defines the technological parameters for microcapsule formulation, and proposes a regulatory roadmap for clinical translation.