Abstract
Purpose
To evaluate and synthesize the existing evidence on the microbiological and human immune response associated with periāimplantitis in comparison to healthy implants.
Materials and methods
Three electronic databases (MEDLINE, Embase, and Cochrane Library) were searched in October 2019 to identify clinical studies evaluating the microbiota and the immune response associated with periāimplantitis. Two reviewers independently screened the studies and used the full text to extract the data. A qualitative synthesis was performed on the extracted data and summary tables were prepared. Due to clinical and methodological heterogeneity among included studies, no metaāanalysis was performed.
Results
Forty studies were included in this review. Of these, 20 studies compared the microbiological profile of periāimplantitis with healthy implants. Nineteen studies focused on the immune response associated with periāimplantitis in comparison to healthy implants. Three studies focus on gene polymorphism associated with periāimplantitis. The most commonly reported bacteria associated with periāimplantitis were obligate anaerobe Gramānegative bacteria (OAGNB), asaccharolytic anaerobic Gramāpositive rods (AAGPRs), and other Gramāpositive species. In regard to immune response, the most frequently reported proāinflammatory mediators associated with periāimplantitis were ILā1Ī², ILā6, ILā17, TNFāĪ±. Osteolytic mediator, e.g., RANK, RANKL, Wnt5a and proteinase enzymes, MMPā2, MMPā9, and CathepsināK were also expressed at higher level in periāimplantitis sites compared to control.
Conclusions
Periāimplantitis is associated with complex and different microbiota than healthy implants including bacteria, archaea, fungi, and virus. This difference in the microbiota could provoke higher inflammatory response and osteolytic activity. All of this could contribute to the physiopathology of periāimplantitis.