The Peri-Implant Sulcus Compared with Internal Implant and Suprastructure Components: A Microbiological Analysis

Abstract

Intra-coronal compartments of screw-retained fixed restorations were heavily contaminated. The restorative margin may have been the principal pathway for bacterial leakage. Contamination of abutment screws most likely occurred from the peri-implant sulcus via the implant-abutment interface and abutment-prosthesis interface.

Bacterial Leakage Along the Implant-Abutment Interface

“…. Cosyn et al (2009), in a short clinical evaluation, have found similarities in the microbiota of samples collected from the internal parts of implants and from their related peri-implant sulci. Another investigations indicated that the existing oral microbiota prior to implant placement is determinant to the establishment and maintenance of the implant related microbiota..…”

“…With time, strict gram-negative anaerobes as Fusobacterium spp and Prevotella spp become increasingly predominant (Mombelli & Mericske-Stern, 1990). Several reports on the microbiota detected around dental implants were published in the last decade (Haffjee et al .,1998;Botero et al, 2005;Cosyn et al, 2009;Van Brakel, et al 2010). Presence of potential periodontal pathogens colonizing the peri-implant grooves in unsuccessful implants has also been described (Laine et al, 2005;Shibli et al, 2007;Persson et al, 2010).…”

“…Excessive premature loading, occlusal trauma and poor bone support are considered the main factors associated with early implant loss (Esposito et al, 2000;Piattelli et al, 2003). Recent reports demonstrated that microorganisms in the oral cavity, especially the ones involved in periodontal diseases, together with unfavorable occlusal factors are considered as the main causes of unsuccessful treatment with implants (Mombelli & Lang, 1998;Covani et al, 2006). A direct correlation between presence of microorganisms and disease of the peri-implant tissues has been demonstrated.…”

“…Hence, microbial colonization of the interfacial gaps may ultimately result in bone resorption (Quirynen et al, 1990;Quirynen et al, 1994;Mombelli et al, 1995). Several in vivo and in vitro studies have shown bacterial leakage through the implantabutment interface, either from the external sites to the inner parts of the implants or viseversa (Quirynen et al,1994;Jansen et al, 1997;Rimondini et al, 2001;Steinebrunner et al,2005;Callan et al, 2005;do Nascimento et al, 2009a;Cosyn et al 2009;Aloise et al, 2010). Other studies, have demonstrated the leakage of dyes and/or bacterial endotoxins through the implant-abutment interface (Gross et al, 1999;Piattelli et al 2001).…”

Dental materials and their performance for the management of screw access channels in implant-supported restorations

“…Up to last year, no evidence was available for induction of peri-implant mucositis or peri-implantitis by internal bacterial contamination. However, some studies have shown internal bacterial infiltration of the implant cavity from an external source and vice versa 10,28,29) . Contamination can be caused by external bacteria trapped during prosthetic placement or as a result of leakage at the implant-abutment interface ( Fig.…”