The microbiologic profile associated with peri-implantitis in humans: A systematic review

Purpose: To qualitatively investigate the microbiologic profile in peri-implantitis by systematically reviewingthe published literature on peri-implant infection. Materials and Methods: Searches of the US NationalInstitutes of Health free digital archives of the biomedical and life sciences journal literature (PubMed)and The Cochrane Library of the Cochrane Collaboration (CENTRAL), as well as a hand search of otherliterature, were conducted to identify articles potentially relevant for the review. Randomized clinicaltrials, prospective cohort studies, longitudinal studies, case-control studies, and cross-sectional studies inhumans reporting microbiologic findings in patients with diagnosed peri-implantitis were considered eligiblefor this review. Screening, data extraction, and quality assessment were conducted independently and induplicate. Results: Twenty-one articles were eligible for inclusion in this review. Early studies focused on theidentification of target periopathogens, whereas more recent studies used advanced molecular techniquesfor comprehensive overview of the peri-implantitis–associated microbiome. In summary, the microbiologicprofile in peri-implantitis (1) is complex and variable, (2) consists of gram-negative anaerobic periopathogensand opportunistic microorganisms in almost the same ratio, (3) is frequently associated with the Epstein-Barrvirus and nonsaccharolytic anaerobic gram-positive rods, (4) is not so strictly associated with Staphylococcusaureus, and (5) is different from that of periodontitis. A meta-analysis could not be performed because ofthe heterogeneity of the reviewed studies. Conclusion: Although a comparison of the published results waslimited because of the inhomogeneity of the studies, it is clear that the microbiologic profile of peri-implantitisconsists of aggressive and resistant microorganisms and is distinct from that of periodontitis. It seems thatthe quantitative characteristics of the microflora cohabitants represent the key determinant of disease,rather than the qualitative composition, which is very similar in healthy and peri-implantitis states