Page 75 - EJMO-9-1

Eurasian Journal of Medicine and
Oncology
Microbial profile of peri-implantitis

cemented-retained implants are no longer recommended surface modifications using nanoparticles. Similarly,
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for use today. microorganisms such as Pseudomonas aeruginosa
Although titanium is considered the material of choice (P. aeruginosa) and S. aureus have shown reduced levels
for dental implants, it has been shown that titanium ions due to nanostructuring of titanium implant surfaces. 44
and the products coating dental implants are associated Polyether ether ketone (PEEK) represents a promising
with dysbiosis in the peri-implant microbiota. This alternative to titanium, with several advantages, including
condition may progress to peri-implantitis. 31 good elasticity, biocompatibility, and excellent esthetics.
However, a major disadvantage of this material is its
Zirconia, as an alternative to titanium, has been modified
with various materials possessing antimicrobial properties, reduced antibacterial potential, which may contribute to
peri-implantitis. Chemical modifications of PEEK, such
such as bioactive ceramics, zinc oxide (ZnO), and silver. Coating as the addition of sulfur, fluorine, and ZnO, have been
zirconia implants with ZnO has demonstrated antimicrobial associated with enhanced bacterial inhibitory potential. 45,46
effects on various peri-implant pathogens, including
Staphylococcus aureus (S. aureus), Escherichia coli (E.coli), and The risk of dental implant loss due to peri-implantitis
Porphyromonas gingivalis (P.gingivalis). 32-34 Furthermore, the is not limited to loaded dental implants, as osseointegrated
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incorporation of silver nanoparticles onto zirconia surfaces implants may fail in the early stages, even before loading.
has shown microbial inhibitory effects against Aggregatibacter However, early loss of dental implants may not always
actinomycetemcomitans (A. actinomycetemcomitans) and be attributed to bacterial causes, as it may result from
Streptococcus mutans (S. mutans). 35 improper surgical techniques or excessive loading during
the healing period. As the saying goes, “The causes are
The comparison between titanium and zirconia remains many, but the result is the same.”
a controversial issue, as previous studies on this subject
have yielded varying results. For instance, one study found The failure of dental implants, whether early or late,
that zirconia is associated with lower bacterial adhesion follows similar outcomes, but the types of microorganisms
compared to titanium, and others reported a lower involved may differ. Studies have shown that certain
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bacterial count on zirconia surfaces than on titanium. 37 microbial species predominate in early implant failure
compared to late failure. For example, Treponema species
In contrast, other studies have not observed significant and T. forsythia were found at higher levels in dental
differences between zirconia and titanium, concluding implants with late failure than in those with early failure.
that both materials have similar bacterial adhesion and Conversely, implants with early failure were more closely
colonization properties. 38,39 In addition, coating titanium associated with species such as Gemella, Fusobacterium,
implants with zirconia have been shown to reduce the and Aggregatibacter. In general, late-failed dental
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levels of P. gingivalis and S. mutans, thereby affecting the implants are associated with a higher microbial load than
biofilm surrounding dental implants. 40 early-failed implants. 48
Despite its high mechanical properties, lower bacterial
adhesion, and biocompatibility, a recent systematic review 7. Surrounding effects
and meta-analysis found that titanium dental implants It has been shown that peri-implant inflammation
had a better survival rate after 1 year compared to zirconia progressed rapidly after oral hygiene measures were
implants. 41 prevented to allow biofilm progression. However, the
In the same context, it has been shown that the clinical signs of inflammation disappear once oral hygiene
nanostructuring of dental implant surfaces increases the measures are resumed.
hydrophilic potential of the surfaces, which in turn leads The association between peri-implant diseases and
to a decrease in the attachment of hydrophobic bacterial biofilm progression on the surface of implants has been
species. This decrease may contribute to the inhibition well-documented. 49,50 In both completely edentulous
of peri-implantitis. Furthermore, surface modification and partially dentate patients, the peri-implant biofilm
through nanostructuring has been associated with an population has been studied. In partially dentate subjects,
increased degree of osseointegration. 42 the environmental conditions differ significantly. As a
A variety of periodontal pathogen species have result, the type of peri-implant biofilms is influenced by
been inhibited by surface modifications of dental the microorganisms present on natural teeth.
implants. The growth of Tannerella forsythia (T. A comprehensive understanding of peri-implant disease
forsythia), Treponema denticola (T. denticola), and P. necessitates an equally thorough understanding of peri-
gingivalis has been shown to be inhibited by titanium implant health. As the saying goes, “To know the disease

Volume 9 Issue 1 (2025) 67 doi: 10.36922/ejmo.6770