Page 76 - EJMO-9-1

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

once, you should know the health twice.” In this context, (i.e., they share the same pathogens), other studies have
characterizing the microflora of healthy peri-implant found that several types of microorganisms associated
structures is essential to elucidating the microbiological with implants are linked to non-oral infections, not just
changes associated with peri-implant disease progression. periodontal infections (e.g., Staphylococcus species, enteric
rods, and yeasts). 17,62,63
8. Health circumstances
It has been shown that the most important periodontal
The mechanism of biofilm formation on implants is quite pathogens, including the red complex bacteria and
similar to that on teeth. Diverse types of microbial A. actinomycetemcomitans, are present in high percentages
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communities accumulate within several weeks or even in nearly all cases of peri-implantitis, alongside other non-
months following exposure to the oral environment. periodontal pathogens. This finding may contribute to
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However, biofilm on the implant surface has been reported confusion regarding the similarity between periodontitis
to form within a few minutes of exposure to the oral and peri-implantitis.
cavity. 17,51 Some studies have found that biofilm formation The oral cavity, skin, and mucus membranes are
around implants requires a longer time for maturation, 52,53 considered natural habitats for Staphylococci. The coagulase-
while another study suggests it takes approximately 14 days positive microorganism S. aureus is an opportunistic
for biofilm organization on the peri-implant surface. 54
pathogen commonly found in post-operative wounds.
It has been observed that one of the most important
S. aureus has several virulence factors that mediate its
periodontal pathogens is absent in edentulous patients. This attachment to orthopedic implants, which forms the basis
finding led to the hypothesis that periodontal pathogens do for relating peri-implantitis with S. aureus. 65-68 However, it
not colonize the surface of implants inserted in edentulous is essential to note that implants in the oral cavity exist in
patients. 15,55,56 However, another study found that a different environment compared to orthopedic implants.
periodontal pathogens could still be present after months Biofilm formation in the oral cavity is initially mediated by
after tooth extraction, suggesting that these pathogens both specific interactions (e.g., with the acquired pellicle)
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may colonize the implant surfaces after insertion.
and non-specific forces (e.g., van der Waals forces). Over
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This hypothesis is supported by more sophisticated time, multiple species of microorganisms coaggregate,
molecular investigations, which have shown that contributing to biofilm development. In addition,
periodontal pathogens can be isolated from dental implant factors such as crevicular fluid, resident microbiota, and
surfaces in both partially and fully edentulous patients. saliva influence the environment and, consequently, the
A wide range of well-known periodontal pathogens, such development of biofilm.
as Streptococcus intermedius, T. denticola, T. forsythia, The microbial profile in peri-implantitis and peri-
P. gingivalis, A. actinomycetemcomitans, and others, have implant mucositis appear to be the same, 69,70 suggesting
been identified in these studies. 58-60
that biofilm development and the onset of peri-implant
In comparison to sites with healthy periodontium, mucositis may be the initiation of peri-implantitis.
dental implants in healthy conditions were found to be Moreover, the depth of pocket around implants is an
associated with microbial profiles similar to those of healthy important determinant of microbial profile. Shallower
periodontal sites, though they showed less complexity. 61 peri-implant pockets have lower anaerobic counts and
One possible explanation for the presence of some a reduced P. gingivalis count, compared to deeper peri-
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periodontal pathogens in peri-implant sites associated implant pockets. Microbial profiles in healthy peri-
with health is that these microorganisms are considered implant, peri-implantitis, and periodontitis sites are.
part of the normal flora found in both periodontal and 9.2. Viral effects
peri-implant conditions. Ultimately, it is the environment
and circumstances that determine whether these It has been shown that viruses play an important role in
microorganisms remain in a state of health or shift into a the pathogenesis of periodontal diseases in natural teeth.
disease state. This role can likely be generalized to peri-implant diseases.
Human cytomegalovirus and Epstein–Barr virus have
9. Peri-implant diseases been associated with peri-implant infections through local
immune inhibition, which allows for the overgrowth of
9.1. Bacterial effect periodontal pathogens, suggesting a potential causative
Although numerous studies suggest that the microbial effect. 72,73 Although many studies have reported that human
profile in implants with peri-implantitis is similar to that cytomegalovirus and Epstein–Barr virus are frequently
of periodontitis, including Gram-negative anaerobes isolated in peri-implantitis, these findings are not strong

Volume 9 Issue 1 (2025) 68 doi: 10.36922/ejmo.6770