**8.8 Implant-related factors**

The titanium particles from the implant surface may be present in the tissues after implant placement and may enhance infection-induced inflammation and activate macrophages [54]. Implant surface characteristics vary in terms of topography, surface roughness, and chemical composition. Currently, most implants have a moderately rough surface with improved bone responses during initial healing after implant placement [55]. Marginal bone loss was found to be greater when implants with rough surfaces were used, and turned surfaces generally demonstrated the smallest marginal bone loss [56, 57].
