Biofilm as a risk factor in implant treatment

Abstract

This article summarizes the microbiological findings at dental implants, drawing distinctions between the peri‐implant microbiome and the periodontal microbiome, and summarizes what is known regarding biofilm as a risk factor for specific stages of implant treatment. Targeted microbial analysis is reviewed as well as the latest results from open‐ended sequencing of the peri‐implant flora. At this time there remains a lack of consensus for a specific microbial profile that is associated with peri‐implantitis, suggesting that there may be other factors which influence the microbiome such as titanium surface dissolution. Therapeutic interventions to address the biofilm are presented at the preoperative, perioperative, and postoperative stages. Evidence supports that perioperative chlorhexidine reduces biofilm‐related implant complications and failure. Regular maintenance for dental implants is also shown to reduce peri‐implant mucositis and implant failure. Maintenance procedures should aim to disrupt the biofilm without damaging the titanium dioxide surface layer in an effort to prevent further oxidation. Evidence supports the use of glycine powder air polishing as a valuable adjunct to conventional therapies for use at implant maintenance visits. For the treatment of peri‐implantitis, nonsurgical therapy has not been shown to be effective, and while surgical intervention is not always predictable, it has been shown to be superior to nonsurgical treatment for decontamination of the implant surface that is not covered by bone.

Material characterization and Streptococcus oralis adhesion on Polyetheretherketone (PEEK) and titanium surfaces used in implantology

“…There were no significant differences for biofilm formation between machined and DAE titanium surfaces: this is the further confirmation, that as shown by Daubert et al the superficial roughness influences the bacterial adhesion and it is fundamental only in the first hours [33].…”

Clinical Efficacy of Adjunctive Chlorhexidine Irrigation to Mechanical Approach in the Treatment of Peri-implant Mucositis: A Pilot Study

“…3 Biyofilm içerisindeki mikroorganizmalar, konak-patojen dengesinde değişime sebep olarak lokal enflamatuvar yanıt ile peri-implant dokularda yıkıma sebep olabilirler. 4,5 İmplantı çevreleyen dokularda meydana gelen patolojik değişikliklerle karakterize peri-implant hastalıklar, peri-implant mukozitis ve peri-implantitis olarak ikiye ayrılmaktadır. Peri-implant mukozitis, klinik olarak implant çevresindeki mukozada kızarıklık, şişlik ve sondalamada kanama (SK) gözlenen ancak destek kemik kaybı görülmeyen geri dönüşümlü bir hastalıktır.…”

“…3,6,7 Doğal dişler çevresinde gözlenen gingivitisle büyük benzerlik gösteren peri-implant mukozitisin patogenezinde de ana etken biyofilm içinde yer alan patojen mikroorganizmalardır. 5,[8][9][10] Yedinci Avrupa Periodontoloji Çalıştayı'nda peri-implant ve periodontal dokularda ortak olarak bulunan epitel bariyerin benzerlikler gösterdiği ancak periimplant dokulardaki yapısal farklılıkların mikroorganizmalara karşı gelişen konak yanıtında etkili olduğuna dair çok az bilgi olduğu belirtilmiştir. 11 Bununla beraber, peri-implant mukozitisin doğru yaklaşımlarla tedavi edildiğinde aynen gingivitis gibi geri dönüşümlü bir hastalık olduğuna dair yeterli kanıt hayvan ve insan çalışmalarıyla ortaya kon-muştur.…”

Concepts for prevention of complications in implant therapy

“…The peri‐implant biofilm composition is more complex when compared with the periodontal sites. Bacterial adhesion on titanium and biofilm formation on ceramic surfaces were discussed according to the current literature and under which circumstances the peri‐implant biofilm maturation will take place. The peri‐implantitis microbiome and its role in control influences implant success rates, as well as peri‐implant mucositis and peri‐implantitis treatment.…”

“…The peri‐implantitis microbiome and its role in control influences implant success rates, as well as peri‐implant mucositis and peri‐implantitis treatment. The control of implant biofilm in the various stages of treatment, such as preoperatively, intraoperatively, postoperatively, and during long‐term maintenance, has been addressed by Daubert and Weinstein in this volume of Periodontology 2000 . The microbiome composition in healthy and inflammatory peri‐implant conditions has also been studied under the influence of environmental factors, such as smoking .…”