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Biofilm Formation on Natural Teeth and Dental Implants: What is the Difference?

Chapter
Part of the Springer Series on Biofilms book series (BIOFILMS, volume 3)

Abstract

Dental plaque is a milieu of microbes embedded within a polymeric layer of glycoproteins precipitated from the saliva onto tooth enamel, dental implants, cementum, and epithelium. This dental biofilm can extend below the gingival margin into the socket where the microorganisms are concealed from the bacteriostatic components in the saliva and the shearing forces exerted by chewing and normal brushing. Gingivitis and periodontal disease occurs when more virulent microbes colonize the subgingival pocket and evade eradication by the host defenses. A distinctive shift in microbial colonization is observed with the progression of disease highlighted by the expansion of gram negative and strictly anaerobic bacteria. Host response and inflammation meant to eliminate the microbial insult are counterproductive and generate a deeper pocket within the dental socket that permits the microbial access to the alveolar bone. Dental implants form another nidus for bacterial infection following surgery when the surface and socket are exposed to the oral environment. Dental implantation may be a direct consequence of periodontal disease; therefore the underlying microbial infection could threaten successful osseointegration of the implant if a microbial biofilm develops. Periodontal pockets and other oral niches, such as the mucosa and tonsils, are reservoirs for the microbial pathogens that initiate the inflammation of the marginal soft tissue around the dental implants that may lead to implant failure. Reduction in peri-implantitis rates are shown when patients delay implant surgery after tooth extraction and rigorous preoperative and postoperative antibiotic regiments as well as improved dental hygiene are incorporated into the post-operative treatment.

Keywords

Dental Implant Periodontal Pocket Periodontal Pathogen Edentulous Patient Supragingival Plaque 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Reference

  1. Alcoforado GA, Rams TE, Feik D, Slots J (1991) Microbial aspects of failing osseointegrated dental implants in humans. J Parodontol 10:11–18PubMedGoogle Scholar
  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 Periodontal Res 24:96–105PubMedCrossRefGoogle Scholar
  3. Augthun M, Conrads G (1997) Microbial findings of deep peri-implant bone defects. Int J Oral Maxillofac Implants 12:106–112PubMedGoogle Scholar
  4. Baron M, Haas R, Dortbudak O, Watzek G (2000) Experimentally induced peri-implantitis: a review of different treatment methods described in the literature. Int J Oral Maxillofac Implants 15:533–544PubMedGoogle Scholar
  5. Berglundh, T, Lindhe J, Marinello C, Ericsson I, Liljenberg B (1992) Soft tissue reaction to de novo plaque formation on implants and teeth. An experimental study in the dog. Clin Oral Implants Res 3:1–8PubMedCrossRefGoogle Scholar
  6. Berry CW, Moore TJ, Safar JA, Henry CA, Wagner MJ (1992) Antibacterial activity of dental implant metals. Implant Dent 1:59–65PubMedCrossRefGoogle Scholar
  7. 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 Periodontol 16:580–587PubMedCrossRefGoogle Scholar
  8. Clarizio LF (2000) Peri-implant infections. Atlas Oral Maxillofac Surg Clin North Am. 8:35–54PubMedGoogle Scholar
  9. Cooper L, Moriarty J (1997) Prosthodontic and periodontal considerations for implant-supported dental restorations. Curr Opin Periodontol 4:119–126PubMedGoogle Scholar
  10. Danser MM, van Winkelhoff AJ, Van der Velden U (1997) Periodontal bacteria colonizing oral mucous membranes in edentulous patients wearing dental implants. J Periodontol 68:209–216PubMedGoogle Scholar
  11. Devides SL, Franco AT (2006) Evaluation of peri-implant microbiota using the polymerase chain reaction in completely edentulous patients before and after placement of implant-supported prostheses submitted to immediate load. Int J Oral Maxillofac Implants 21:262–269PubMedGoogle Scholar
  12. Ellen RP (1998) Microbial colonization of the peri-implant environment and its relevance to long-term success of osseointegrated implants. Int J Prosthodont 11:433–441PubMedGoogle Scholar
  13. Esposito M, Hirsch JM, Lekholm U, Thomsen P (1998) Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis. Eur J Oral Sci 106:721–764PubMedCrossRefGoogle Scholar
  14. Fardai O, Johannessen AC, Olsen I (1999) Severe, rapidly progressing peri-implantitis. J Clin Periodontol 26:313–317CrossRefGoogle Scholar
  15. Gao N, Xiao X, Chai F, Xian S, Zhu Z, Liu Y (2002) [The influence of two implant materials on the growth of three subgingival predominant bacteria]. Hua Xi Yi Ke Da Xue Xue Bao 33:62–4, 107PubMedGoogle Scholar
  16. George K, Zafiropoulos GG, Murat Y, Hubertus S, Nisengard RJ (1994) Clinical and microbiological status of osseointegrated implants. J Periodontol 65:766–770PubMedGoogle Scholar
  17. Haffajee AD, Socransky SS (2000) Microbial etiological agents of destructive periodontal diseases. Periodontol 1994 5:78–111Google Scholar
  18. Hultin M, Bostrom L, Gustafsson A (1998) Neutrophil response and microbiological findings around teeth and dental implants. J Periodontol 69:1413–1418PubMedGoogle Scholar
  19. Hultin M, Gustafsson A, Hallstrom H, Johansson LA, Ekfeldt A, Klinge B (2002) Microbiological findings and host response in patients with peri-implantitis. Clin Oral Implants Res 13:349–358PubMedCrossRefGoogle Scholar
  20. Kalykakis GK, Mojon P, Nisengard R, Spiekermann H, Zafiropoulos GG (1998) Clinical and microbial findings on osseo-integrated implants; comparisons between partially dentate and edentulous subjects. Eur J Prosthodont Restor Dent 6:155–159PubMedGoogle Scholar
  21. Klinge B (1991) Implants in relation to natural teeth. J Clin Periodontol 18:482–487PubMedCrossRefGoogle Scholar
  22. Klinge B, Hultin M, Berglundh T (2005) Peri-implantitis. Dent Clin North Am 49:661,viiiPubMedCrossRefGoogle Scholar
  23. Laine P, Salo A, Kontio R, Ylijoki S, Lindqvist C, Suuronen R (2005) Failed dental implants — clinical, radiological and bacteriological findings in 17 patients. J Craniomaxillofac Surg 33:212–217PubMedGoogle Scholar
  24. Le GL, Soueidan A, Layrolle P, Amouriq Y (2007) Surface treatments of titanium dental implants for rapid osseointegration. Dent Mater 23:844–854CrossRefGoogle Scholar
  25. Lee KH, Maiden MF, Tanner AC, Weber HP (1999) Microbiota of successful osseointegrated dental implants. J Periodontol 70:131–138PubMedCrossRefGoogle Scholar
  26. Leonhardt A, Renvert S, Dahlen G (1999) Microbial findings at failing implants. Clin Oral Implants Res 10:339–345PubMedCrossRefGoogle Scholar
  27. Lindeboom JA, Tjiook Y, Kroon FH (2006) Immediate placement of implants in periapical infected sites: a prospective randomized study in 50 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101:705–710PubMedCrossRefGoogle Scholar
  28. Listgarten, MA, Lai CH (1999) Comparative microbiological characteristics of failing implants and periodontally diseased teeth. J Periodontol 70:431–437PubMedCrossRefGoogle Scholar
  29. Marsh PD (2003) Plaque as a biofilm: pharmacological principles of drug delivery and action in the sub- and supragingival environment. Oral Dis 9(Suppl 1):16–22PubMedCrossRefGoogle Scholar
  30. Meffert RM (1996) Periodontitis vs. peri-implantitis: the same disease? The same treatment? Crit Rev Oral Biol Med 7:278–291PubMedCrossRefGoogle Scholar
  31. Mombelli A, Mericske-Stern R (1990) Microbiological features of stable osseointegrated implants used as abutments for overdentures. Clin Oral Implants Res 1:1–7PubMedCrossRefGoogle Scholar
  32. Mombelli A, Buser D, Lang NP (1988) Colonization of osseointegrated titanium implants in edentulous patients. Early results Oral Microbiol Immunol 3:113–120CrossRefGoogle Scholar
  33. Mombelli A, Marxer M, Gaberthuel T, Grunder U, Lang NP (1995) The microbiota of osseointegrated implants in patients with a history of periodontal disease. J Clin Periodontol 22:124–130PubMedGoogle Scholar
  34. Nakazato G, Tsuchiya H, Sato M, Yamauchi M (1989) In vivo plaque formation on implant materials. Int J Oral Maxillofac Implants 4:321–326PubMedGoogle Scholar
  35. Nakou M, Mikx FH, Oosterwaal PJ, Kruijsen JC (1987) Early microbial colonization of permucosal implants in edentulous patients. J Dent Res 66:1654–1657PubMedGoogle Scholar
  36. Newman MG, Flemmig TF (1988) Periodontal considerations of implants and implant associated microbiota. J Dent Educ 52:737–744PubMedGoogle Scholar
  37. Novaes AB Jr, Novaes AB (1995) Immediate implants placed into infected sites: a clinical report. Int J Oral Maxillofac Implants 10:609–613PubMedGoogle Scholar
  38. Papaioannou W, Quirynen M, Nys M, van SD (1995) The effect of periodontal parameters on the subgingival microbiota around implants. Clin Oral Implants Res 6:197–204PubMedCrossRefGoogle Scholar
  39. Papaioannou W, Quirynen M, van SD (1996) The influence of periodontitis on the subgingival flora around implants in partially edentulous patients. Clin Oral Implants Res 7:405–409PubMedCrossRefGoogle Scholar
  40. Paquette DW, Brodala N, Williams RC (2006) Risk factors for endosseous dental implant failure. Dent Clin North Am 50:361–374, viPubMedCrossRefGoogle Scholar
  41. Pontoriero R, Tonelli MP, Carnevale G, Mombelli A, Nyman SR, Lang NP (1994) Experimentally induced peri-implant mucositis. A clinical study in humans. Clin Oral Implants Res 5:254–259PubMedCrossRefGoogle Scholar
  42. Quirynen M, Listgarten MA (1990) Distribution of bacterial morphotypes around natural teeth and titanium implants ad modum Branemark. Clin Oral Implants Res 1:8–12PubMedCrossRefGoogle Scholar
  43. Quirynen M, Bollen CM, Eyssen H, van SD (1994) Microbial penetration along the implant components of the Branemark system. An in vitro study. Clin Oral Implants Res 5:239–244PubMedCrossRefGoogle Scholar
  44. Quirynen M, De SM, van SD (2002) Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res 13:1–19PubMedCrossRefGoogle Scholar
  45. Roos-Jansaker AM, Renvert H, Lindahl C, Renvert S (2006) Nine- to fourteen-year follow-up of implant treatment. Part III: factors associated with peri-implant lesions. J Clin Periodontol 33:296–301PubMedCrossRefGoogle Scholar
  46. Rosenberg ES, Torosian JP, Slots J (1991) Microbial differences in 2 clinically distinct types of failures of osseointegrated implants. Clin Oral Implants Res 2:135–144PubMedCrossRefGoogle Scholar
  47. Saadoun AP, Le GM, Kricheck M (1993) Microbial infections and occlusal overload: causes of failure in osseointegrated implants. Pract Periodontics Aesthet Dent 5:11–20PubMedGoogle Scholar
  48. Salcetti JM, Moriarty JD, Cooper LF, Smith FW, Collins JG, Socransky SS, Offenbacher S (1997) The clinical, microbial, and host response characteristics of the failing implant. Int J Oral Maxillofac Implants 12:32–42PubMedGoogle Scholar
  49. Shaffer MD, Juruaz DA, Haggerty PC (1998) The effect of periradicular endodontic pathosis on the apical region of adjacent implants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:578–581PubMedCrossRefGoogle Scholar
  50. Silness J, Loe H (1966) Periodontal disease in pregnancy. 3. Response to local treatment. Acta Odontol Scand 24:747–759PubMedCrossRefGoogle Scholar
  51. Sundqvist G (1992a) Associations between microbial species in dental root canal infections. Oral Microbiol Immunol 7:257–262PubMedCrossRefGoogle Scholar
  52. Sundqvist G (1992b) Ecology of the root canal flora. J Endod 18:427–430PubMedCrossRefGoogle Scholar
  53. Theilade E, Wright WH, Jensen SB, Loe H (1966) Experimental gingivitis in man. II. A longitudinal clinical and bacteriological investigation. J Periodontal Res 1:1–13:1–13PubMedCrossRefGoogle Scholar
  54. Tonetti MS (1998) Risk factors for osseodisintegration. Periodontol 2000 17:55–62PubMedCrossRefGoogle Scholar
  55. Tonetti MS, Imboden M, Gerber L, Lang NP (1995) Compartmentalization of inflammatory cell phenotypes in normal gingiva and peri-implant keratinized mucosa. J Clin Periodontol 22:735–742PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2008

Authors and Affiliations

  1. 1.Endodontics, Prosthodontics and Operative Dentistry, Dental SchoolUniversity of Maryland-BaltimoreBaltimoreUSA
  2. 2.Department of Periodontics, Dental SchoolUniversity of Maryland-BaltimoreBaltimoreUSA
  3. 3.Department of Microbial PathogenesisUniversity of Maryland - Baltimore, Dental SchoolBaltimoreUSA

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