Microbial Community-Driven Etiopathogenesis of Peri-Implantitis

Abstract

Osseointegrated dental implants are a revolutionary tool in the armament of reconstructive dentistry, employed to replace missing teeth and restore masticatory, occlusal, and esthetic functions. Like natural teeth, the orally exposed part of dental implants offers a pristine nonshedding surface for salivary pellicle-mediated microbial adhesion and biofilm formation. In early colonization stages, these bacterial communities closely resemble those of healthy periodontal sites, with lower diversity. Because the peri-implant tissues are more susceptible to endogenous oral infections, understanding of the ecological triggers that underpin the microbial pathogenesis of peri-implantitis is central to developing improved prevention, diagnosis, and therapeutic strategies. The advent of next-generation sequencing (NGS) technologies, notably applied to 16S ribosomal RNA gene amplicons, has enabled the comprehensive taxonomic characterization of peri-implant bacterial communities in health and disease, revealing a differentially abundant microbiota between these 2 states, or with periodontitis. With that, the peri-implant niche is highlighted as a distinct ecosystem that shapes its individual resident microbial community. Shifts from health to disease include an increase in diversity and a gradual depletion of commensals, along with an enrichment of classical and emerging periodontal pathogens. Metatranscriptomic profiling revealed similarities in the virulence characteristics of microbial communities from peri-implantitis and periodontitis, nonetheless with some distinctive pathways and interbacterial networks. Deeper functional assessment of the physiology and virulence of the well-characterized microbial communities of the peri-implant niche will elucidate further the etiopathogenic mechanisms and drivers of the disease.

Discriminating Microbial Community Structure Between Peri-Implantitis and Periodontitis With Integrated Metagenomic, Metatranscriptomic, and Network Analysis

“…These results provide information on novel biomarkers for risk prevention and analytical support for the treatment of peri-implantitis. One recent review also mentioned that microbiological studies based on next-generation sequencing technologies can help to reveal the microbial pathogenesis of peri-implantitis and to develop improved preventative, diagnostic, and therapeutic strategies (Belibasakis and Manoil, 2020). One limitation of this study is that different subjects were used for each type of analysis.…”

How Do Polymer Coatings Affect the Growth and Bacterial Population of a Biofilm Formed by Total Human Salivary Bacteria?—A Study by 16S-RNA Sequencing

“…Tannerella forsythia , Prevotella denticola , Filifactor alocis , Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans have been frequently associated with periodontitis [ 9 , 10 ]. Oral biofilms are also considered the cause of peri-implantitis, an oral implant-associated disease that is correlated with bone loss and subsequent treatment failure [ 11 ]. A shift in the subgingival oral biofilm composition with increased levels of Fusobacterium nucleatum , Porphyromonas gingivalis , Prevotella spp., and Tannerella forsythia has been shown to be associated with peri-implantitis [ 12 , 13 ].…”

“…From an ecological perspective, it should be emphasized that all oral infections are semi-specific and should be considered as cause of the total microbiota composition of the oral biofilm, rather than by specific species. The oral health status is the consequence of a subtle equilibrium between the host and the microbiota [ 14 ], whereby a destruction of this balance can lead to oral diseases such as caries, periodontitis, and peri-implantitis [ 11 , 15 ].…”

“…In these studies, the effect of the coating on one bacterial species is typically evaluated, while their impact on mixed bacterial populations within biofilms is much less understood. Due to the relevance of bacterial biofilms in the loss of dental implants [ 11 , 12 ], the aim of this study was to ascertain whether and how polymer coatings affect biofilm formation and composition after incubating these materials with total human saliva. This should answer the question of whether and how the presence of bioactive polymer coatings affect the microbial population balance of bacteria in biofilms formed by total salivary bacteria, in particular whether the known oral health-associated equilibrium within the oral biofilm would be assisted or disturbed by such materials.…”

At which bone level are implants explanted?

“…The microbiota of peri‐implantitis and periodontitis are comparable although peri‐implantitis is a more complex and heterogeneous infection (Eick et al., 2016; Lafaurie et al., 2017). The shift from a healthy peri‐implant situation to peri‐implantitis goes along with a gradual decrease of commensal bacteria and an increase in putative typically periodontitis associated pathogens (Belibasakis & Manoil, 2020). Also, the number of bacteria increases with progressing marginal bone loss (Monje et al., 2020).…”