Longitudinal studies have shown that successful implants are colonized by a predominantly Gram-positive, facultative flora, which is established shortly after implantation. Repeated microbiological sampling in patients with clinically stable implants showed no significant shifts in the composition of this flora over five years. In patients with bone loss and pocket formation around implants, however, a significantly different flora was found: Gram-negative anaerobic bacteria, particularly fusobacteria, spirochetes, and black-pigmenting organisms such as Prevotella intermedia were often present in high proportions. Antimicrobial treatment with agents specifically active against anaerobes could halt progression of peri-implant infections in such cases. Although there may be non-microbial primary causes for implant failure, these studies show that Gram-negative anaerobes may play a role in peri-implant infections, and that their elimination leads to improvement of the clinical condition.
Get full access to this article
View all access options for this article.
References
1.
Alcoforado Gap, Rams TE, Feik D., Slots J. (1991). Aspects bacteriologiques des echecs des implants dentaires osteointegres chez l'homme. Parodontologie10:11-18.
2.
Apse P., Ellen RP, Overall CM, Zarb GA ( 1989). Microbiota and crevicular fluid collagenase activity in the osseointegrated dental implant sulcus: A comparison of sites in edentulous and partially edentulous patients. J Periodont Res24:96-105.
3.
Becker W., Becker BE, Newman MG, Nyman S. (1990). Clinical and microbiologic findings that may contribute to dental implant failure. Int J Oral Maxillofac Surg5:31-38.
4.
Bower RC, Radny NR, Wall CD, Henry PJ (1989). Clinical and microscopic findings in edentulous patients 3 years after incorporation of osseointegrated implant-supported bridgework. J Clin Periodontol16:580-587.
5.
Crawford JJ (1984). Orofacial infections and antibiotic management . In: Newman MG, Goodman AD, editors. Guide to antibiotic use in dental practice. Chicago: Quintessence , 25-38.
6.
Ericsson I., Lekholm U., Branemark P-I., Lindhe J., Glantz P.-O, Nyman S. (1986). A clinical evaluation of fixed-bridge restorations supported by the combination of teeth and osseointegrated titanium implants . J Clin Periodontol13:307-312.
7.
Flemmig TF, Berwick Rhf, Newman MG, Kenney EB, Beumer J., Nachnani S., et al. (1989). Effekt des Recalls auf die subgingivale Mikroflora von osseointegrierten Implantaten. Hamburg: Tagung des Arbeitskreises fur Implantologie innerhalb der Deutschen Gesellschaft für Zahn-, Mundund Kieferheilkunde.
8.
Fujioka-Hirai Y., Akagawa Y., Minagi S., Tsuru H., Miyake Y., Suginaka H. (1987). Adherence of Streptococcus mutans to implant materials . Biomed Mater Res21:913-920.
9.
GristinaAG (1987). Biomaterial-centered infection: Microbial adhesion versus tissue integration. Science237:1588-1595.
10.
Joshi RI, Eley A. ( 1988). The in vitro effect of a titanium implant on oral microflora: comparision with other metallic compounds. J Med Microbiol27:105-107.
11.
Kornman KS (1982). Age, supragingival plaque, and steroid hormones as ecological determinants of the subgingival flora. In: Genco RJ, Mergenhagen SE, editors. Host-parasite interactions in periodontal disease . Washington (DC): American Society for Microbiology, 132-138.
12.
Lekholm U., Adell R., Lindhe J., Branemark P., Eriksson B., Rockler B., et al. (1986). Marginal tissue reactions at osseointegrated titanium fixtures. Int J Oral Maxillofac Surg15:53-61.
13.
Leonhardt A., Berglundh T., Ericsson I., Dahlen G. (1992). Putative periodontal pathogens on titanium implants and teeth in experimental gingivitis and periodontitis in beagle dogs. Clin Oral Impl Res3:112-119.
14.
Loesche WJ, Gusberti F., Mettraux G., Higgins T., Syed S. ( 1983). Relationship between oxygen tension and subgingival bacterial flora in untreated human periodontal pockets. Infect Immun42:659-667.
15.
Mergenhagen SE, Rosan B, editors (1985). Molecular basis of oral microbial adhesion. Washington (DC): American Society for Microbiology.
16.
Mombelli A., Mericske-Stern R. (1990). Microbiological features of stable osseointegrated implants used as abutments for overdentures. Clin Oral Impl Res1:1-7.
17.
Mombelli A., Lang NP ( 1992). Antimicrobial treatment of periimplant infections . Clin Oral Impl Res3:162-168.
18.
Mombelli A., Van Oosten Mac, Schürch E., Lang NP ( 1987). The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol2:145-151.
19.
Mombelli A., Buser D., Lang NP ( 1988). Colonization of osseointegrated titanium implants in edentulous patients. Early results. Oral Microbiol Immunol3:113-120.
20.
Nakazato G., Tsuchiya H., Sato M., Yamauchi M. (1986). In vivo plaque formation on implant materials . Int J Oral Maxillofac Implants4:321-325.
21.
Nakou M., Mikx Fhm, Oosterwaal Pjm, Kruijsen Jcwm (1987). Early microbial colonization of permucosal implants in edentulous patients. J Dent Res11:1654-1657.
22.
Rams TE, Link CC ( 1983). Microbiology of failing dental implants in humans: electron microscopic observations. J Oral Implantol11:93-100.
23.
Rams TE, Roberts TW, Tatum H. Jr, Keyes PH (1984). The subgingival microbial flora associated with human dental implants. J Prosthet Dent51:529-534.
24.
Rams TE, Feik D., Slots J. (1990). Staphylococci in human periodontal diseases. Oral Microbiol Immunol5:29-32.
25.
Rosenberg ES, Torosian JP, Slots J. (1991). Microbial differences in 2 clinically distinct types of failures of osseointegrated implants. Clin Oral Impl Res2:135-144.
26.
Sanz M., Newman MG, Nachnani S., Holt R., Stewart R., Flemmig T. (1990). Characterization of the subgingival microbial flora around endosteal sapphire dental implants in partially edentulous patients . Int J Oral Maxillofac Implants5:247-253.
27.
Socransky SS, Haffajee AD, Dzink JL, Hillman JD (1988). Association between microbial species in subgingival plaque samples. Oral Microbiol Immunol3:1-7.
28.
Ter Steeg PF, Van der Hoeven JS (1990). Growth stimulation of Treponema denticola by periodontal microorganisms. Antonie van Leeuwenhoek57:63-70.
29.
Theilade E., Theilade J. (1985). Formation and ecology of plaque at different locations in the mouth. Scand J Dent Res93:90-95.
30.
Van Houte J. (1982). Colonization mechanisms involved in the development of the oral flora. In: Genco RJ, Mergenhagen SE, editors. Host-parasite interactions in periodontal disease. Washington (DC): American Society for Microbiology, 86-97.
31.
Van Steenbergen Tjm, Van Winkelhoff AJ, De Graaff J. (1991). Black-pigmented oral anaerobic rods: Classification and role in periodontal disease. In: Hamada S, Holt SC, McGhee JR, editors. Periodontal disease: Pathogens & host immune responses. Tokyo: Quintessence Publishing Co., 41-52.
32.
Wolff LF, Liljemark WF, Pihlstrom BL, Schaffer EM, Aeppli DM, Bandt CL (1988). Dark-pigmented Bacteroides species in subgingival plaque of adult patients on a rigorous recall program. J Periodont Res23:170-174.
33.
Wolinsky LE, de Camargo PM, Erard JC, Newman MG (1989). A study of in vitro attachment of Streptococcus sanguis and Actinomyces viscosusto saliva-treated titanium. Int J Oral Maxillofac Implants4:27-31.
