However, in most patients, the local bone amount is reduced due to atrophy, inflammatory processes, or resectional defects. Therefore, in the past few years, different techniques have been described to enlarge the local bone amount in prospective implant sites [7]. Besides methods such as GBR or the sinus augmentation technique, different augmentation materials have been investigated and established in the daily clinical routine. Autologous bone in the context of hard tissue augmentations is still the gold standard due to its osteogenic capacity [8]. To avoid the disadvantages that come with autologous bone transfer, such as a second surgical site and an increase in postoperative pain, biomaterial research has focused on the development of bone substitute materials that serve as scaffolds for the ingrowth of bone and its progenitor cells from the surrounding tissue [9].

The ability of bone substitute materials to form a sufficient and stable implantation bed has been proven in numerous clinical trials; however, it is still to a certain degree unclear if the different tissue reactions have an impact on the establishment of a peri-implant infection, especially when these biomaterials are used for augmentations around the implant shoulder. Due to the two-stage design of the implant, the implant shoulder presents a potential micro-gap between the abutment and the implant and a port of entry for microorganisms and peri-implant infections leading to a manifestation of peri-implantitis [10].