Canullo L, Orlato Rossetti PH, Tallarico M, Peñarrocha Oltra D. Identification of Staphylococcus aureus at the internal and external implant surfaces in individuals with periimplant disease: a cross-sectional study. J Oral Science Rehabilitation. 2016 Mar;2(1):8–13.
In the past 30 years, the materials and methods of implant dentistry have undergone a substantial process of development and evolution. Implant surface, macrodesign and type of implant–abutment connection have been found to be of major relevance to initial healing and long-term stability. Since the number of implants placed has increased in the last ten years, optimal maintenance has become increasingly important. While in many cases, it has been reported that dental implants are a safe and predictable treatment method with high survival rates, they are not immune from biological and iatrogenic complications associated with improper treatment planning, surgical and prosthetic execution, or material failure, as well as maintenance problems. Also, the biological complications of periimplant mucositis and periimplantitis, which may result in soft- and hard-tissue defects, have been suggested to be relevant for later marginal bone loss.
Several approaches have been followed in seeking to understand the pathomechanism of periimplantitis. According to a consensus conference of the American Academy of Periodontology, bacterial colonization of the implant surface and the occurrence of bone loss indicate the point of no return in periimplantitis.8 Periimplantitis is characterized by an inflammatory process around an implant that includes both soft-tissue inflammation and progressive loss of periimplant supporting bone. Periimplantitis occurs primarily as a result of overwhelming periodontal insult and subsequent immune response.9 The connection to periodontitis as an infectious disease with comparable symptoms and outcomes suggests that investigating the associated local bacteria is fundamental to establishing the pathomechanism of periimplantitis.