Journal of Dental Implants

CASE REPORT
Year
: 2011  |  Volume : 1  |  Issue : 1  |  Page : 26--28

Detection of sub-gingival periodonto-pathogenic microorganisms around a one-stage implant supported prosthesis


Sultan Zeb Khan1, Nobuhiro Sasaki2, Noriko Sasaki2, Ritsugo Hirose2, Kuniko Hirose2, Kaichi Matsuoka2, Hiroshi Furuya2, Takashi Inoue3,  
1 Department of Clinical Pathophysiology, Tokyo Dental College, Mihama-Ku, Chiba;Katsutadai Dental Clinic, Japan
2 Katsutadai Dental Clinic, Japan
3 Department of Clinical Pathophysiology, Tokyo Dental College, Mihama-Ku, Chiba, Japan

Correspondence Address:
Sultan Zeb Khan
Clinical Pathophysiology Department, Tokyo Dental College Graduate School, 1-2-2 Masago, Mihama-Ku, Chiba 261-8502
Japan

Abstract

The purpose of this study is to determine the predominant periodontopathogenic microbiota in peri-implant sulcus of osseointegrated implant of a healthy patient. A healthy patient with good periodontal condition was selected for AQB single-piece implant placement. Periodontal pathogens were checked in patient«SQ»s saliva prior to implantation. F. nucleatum (0.25%) and B. forsythensis (0.01%) were detected. An HA-coated one-stage implant (AQB) was implanted in the missing lower second molar region. Then samples were collected from the peri-implant sulcus using paper point, every month for eight months after the implantation and fixation of porcelain crown. RT-PCR (invader method) was used to detect the periodontal pathogens. No periodontal pathogens were observed up to three months. F. nucleatum (0.16 %) was detected at three months, T. forsythensis (0.06%) and F. nucleatum (0.06%) were detected after four months. A. actinomycetemcomitans (0.054%) and F. nucleatum (3.29%), were detected at six months. F. nucleatum (5%), (1.58%) were detected at seventh and eighth month.



How to cite this article:
Khan SZ, Sasaki N, Sasaki N, Hirose R, Hirose K, Matsuoka K, Furuya H, Inoue T. Detection of sub-gingival periodonto-pathogenic microorganisms around a one-stage implant supported prosthesis.J Dent Implant 2011;1:26-28


How to cite this URL:
Khan SZ, Sasaki N, Sasaki N, Hirose R, Hirose K, Matsuoka K, Furuya H, Inoue T. Detection of sub-gingival periodonto-pathogenic microorganisms around a one-stage implant supported prosthesis. J Dent Implant [serial online] 2011 [cited 2020 Oct 21 ];1:26-28
Available from: https://www.jdionline.org/text.asp?2011/1/1/26/76429


Full Text

 Introduction



An implant-supported prosthesis is the most common choice to replace lost teeth in edentulous and partially edentulous patients. Success and functional durability mainly depends on biomechanical factors and the absence of periodontal infection. [1] Peri-implantitis is frequently found in patients with poor plaque control, and can result in implant failure. Aggregatibacter actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis and Prevotella intermedia have been detected in periodontally diseased patients. These periodontal pathogens have also been reported in both subgingival and supragingival plaque in periodontally healthy patients. [2] Few studies, however, have investigated major periodontal pathogens present around endosseous dental implants in periodontally healthy patients. This case report describes a longitudinal prospective study of periodontal pathogens in a healthy patient observed every month over an eight-month period using RT-PCR.

 Case Report



A 59­-year-old woman was admitted to the Katsutadai Dental Clinic with a missing mandibular second molar.

A check of the patient's saliva for periodontal pathogens prior to implantation revealed F. nucleatum (0.25%) and B. forsythensis (0.01%). However, the patient was comparatively healthy in terms of periodontal condition. An HA- coated one- stage implant (AQB) was inserted in the second molar region, after which, samples were taken from the peri-implant sulcus using a paper point, every month over an eight-month period for analysis by RT-PCR (invader method). The prosthesis was placed two months post-implantation.

Sequential pre- and post- implantation digital radiographs and clinical photos [Figure 1],[Figure 2],[Figure 3],[Figure 4],[Figure 5],[Figure 6].{Figure 1}{Figure 2}{Figure 3}{Figure 4}{Figure 5}{Figure 6}

 Results



No periodontal pathogens were observed for up to three months.

At the third month, F. nucleatum (0.16 %) was noted. T. forsythensis (0.06%) and F. nucleatum (0.06%) were detected at four months. A. actinomycetemcomitans (0.054%) and F. nucleatum (3.29%), were detected at six months, and F. nucleatum was detected at seventh months (5%) and eighth months (1.58%) [Table 1].{Table 1}

 Discussion



Ellen et al.[3] and Kalykakis et al., [4] found that periodontal and peri-implant microflora showed similar tendencies during progressive deterioration of supporting structures. Becker et al.[4] reported moderate levels of Aggregatibacter actinomycetemcomitans, Bacteroides intermedius, and Porphymonas gingivalis at failing implant sites. Jasenka Zivko-Babic et al, [5] have reported A. actinomycetemcomitans and F. nucleatum as the major periodontal pathogens in subgingival microflora in patients with implant-supported restorations. However, Prevotella intermedia, Prevotella oralis and Campylobacter rectus were found infrequently. In the present study, we found A. actinomycetemcomitans, P. gingivalis, T. forsythensis and F. nucleatum. F. nucleatum, in particular, was found almost every month, either alone or in combination with other pathogens, and showed the maximum value at seven months. These pathogens were found in periodontally healthy patients, indicating the importance of oral hygiene by the patient as well as the need for professional periodontal maintenance. Hellstrom et al., [6] reported that professional maintenance and self plaque control had a positive effect on sub-gingival micro-flora. In this study, the patient's pre-implantation plaque index was 3.8%, probing depth (more than 4 mm) was 0.6%, and bleeding index was 0%. This illustrates the importance of good oral hygiene in the maintenance of plaque control and professional periodontal treatment in the early detection and elimination of potentially pathogenic microbiota. Pre-implant periodontal therapy can reduce or eliminate peri-implant periodontal pathogens, and may increase the functional durability of the implant-supported prosthesis itself.

 Conclusion



The results suggest that it is important to examine the presence of periodontal pathogens after implantation, and particularly after placement of prosthesis to avoid peri-implantitis.

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