ABSTRACT
PURPOSE: A recent in vivo study has shown considerable contamination of internal implant and suprastructure components with great biodiversity, indicating bacterial leakage along the implant-abutment interface, abutment-prosthesis interface, and restorative margins. The goal of the present study was to compare microbiologically the peri-implant sulcus to these internal components on implants with no clinical signs of peri-implantitis and in function for many years. Checkerboard DNA-DNA hybridization was used to identify and quantify 40 species. MATERIAL AND METHODS: Fifty-eight turned titanium Brånemark implants in eight systemically healthy patients (seven women, one man) under regular supportive care were examined. All implants had been placed in the maxilla and loaded with a screw-retained full-arch bridge for an average of 9.6 years. Gingival fluid samples were collected from the deepest sulcus per implant for microbiological analysis. As all fixed restorations were removed, the cotton pellet enclosed in the intra-coronal compartment and the abutment screw were retrieved and microbiologically evaluated. RESULTS: The pellet enclosed in the suprastructure was very similar to the peri-implant sulcus in terms of bacterial detection frequencies and levels for practically all the species included in the panel. Yet, there was virtually no microbial link between these compartments. When comparing the abutment screw to the peri-implant sulcus, the majority of the species were less frequently found, and in lower numbers at the former. However, a relevant link in counts for a lot of bacteria was described between these compartments. Even though all implants in the present study showed no clinical signs of peri-implantitis, the high prevalence of numerous species associated with pathology was striking. CONCLUSIONS: 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.
Subject(s)
Dental Abutments/microbiology , Dental Implant-Abutment Design , Dental Implants/microbiology , Gingival Crevicular Fluid/microbiology , Gram-Negative Bacteria/classification , Gram-Positive Bacteria/classification , Alveolar Bone Loss/classification , Bacterial Load , Campylobacter/isolation & purification , Capnocytophaga/isolation & purification , DNA, Bacterial/analysis , Dental Leakage/microbiology , Dental Materials/chemistry , Dental Plaque/microbiology , Dental Plaque Index , Female , Fusobacterium/isolation & purification , Humans , Male , Middle Aged , Nucleic Acid Hybridization , Periodontal Index , Periodontal Pocket/classification , Periodontal Pocket/microbiology , Streptococcus oralis/isolation & purification , Titanium/chemistryABSTRACT
Proper examination of patients is essential in assessing treatment needs. This includes at least a thorough anamnesis and clinical examination. As periodontal diseases are highly-prevalent in Belgium, every patient should be examined as such on a routine basis in general practice. After all, early detection of pathology avoids extensive periodontal therapy and favours tooth retention in the end, which is the ultimate goal. This manuscript offers the clinician, in particular the general practitioner, a number of guidelines in reference to periodontal diagnosis.
