Microbiome of peri-implant infections: Lessons from conventional, molecular and metagenomic analyses

Abstract

Osseointegrated dental implants are now a well-established treatment option in the armament of restorative dentistry. These technologically advanced devices are designed to functionally and esthetically replace missing teeth. Despite the revolutionary advances that implants have incurred, they have also provided the oral cavity with new artificial surfaces prone to the formation of oral biofilms, similarly to the hard tissue surfaces of natural teeth. Biofilm formation on the implant surface can trigger the inflammatory destruction of the peri-implant tissue, in what is known as peri-implantitis. The mixed microbial flora of peri-implant infections resembles that of periodontal infections, with some notable differences. These are likely to expand with the ever increasing application of metagenomics and metatrascriptomics in the analysis of oral ecology. This review presents the wealth of knowledge we have gained from microbiological methods used in the characterization of peri-implant microflora and sheds light over potential new benefits, as well as limitations, of the new sequencing technology in our understanding of peri-implant disease pathogenesis.

Microbial Profiles and Detection Techniques in Peri-Implant Diseases: a Systematic Review

“…PCR as the first technique of a group identified as “molecular techniques”, was introduced in the 80s. It uses an enzymatic replication process of the DNA that will be later observed in a gel or quantified after a number of replication cycles [3]. These techniques overcame the limitations of culturing techniques and also allowed great time-saving.…”

“…Peri-implant diseases are a prevalent reality: 19 to 65% of implants present peri-implant mucositis (weighted mean of 43% [CI = 32 to 54%]) and 1 to 47% develop peri-implantitis (weighted mean of 22% [CI = 14 to 30%]) alongside a positive relationship with function time [1]. Moreover, peri-implant diseases are challenging to treat [2], and, in some cases, with aggressive progression patterns [3]. However, consensus has been reached so far only on few facts associated with increased risk of peri-implant disease development: 1) lack of regular supportive therapy; 2) plaque accumulation; 3) smoking; 4) history of periodontal disease; and 5) excess cement [4].…”

“…The ecological succession of the microbes in the sulcus may lead to the development of the disease. The peri-implant disease has been described as poly-microbial anaerobic infection similar to that found in chronic periodontitis [3,26,27]. However, new technologies are finding an increasing number of microorganisms in peri-implant sites not found around teeth [4].…”

Oral Health: The Need for Both Conventional Microbial and Molecular Characterization

“…There are relatively few studies that have used molecular approaches to characterize the peri-mucositis and peri-implantitis microbiota [49]. The use of 16S-based sequencing suggests that the peri-implant microbiome may be distinct from that of the periodontal microbiome.…”

Oral infections: clinical and biological perspectives

“…28,29 Charalampakis and Belibasakis review the current knowledge on the microbiology of peri-implant infections gained from various methodological approaches, discussing their benefits and limitations. 30 While there are considerable similarities in microbial profiles between periodontal and peri-implant infections, there are also distinctive differences, which are expected to become more diversified with the increasing application of metagenomics platforms.…”