While osseointegration has transformed oral rehabilitation, long-term success depends heavily on the delicate equilibrium between host tissues and the surrounding microbial ecosystem.
The narrative review titled “The Oral Microbiome of Peri-Implant Health and Disease” published in MDPI (Dentistry Journal) provides a comprehensive and up-to-date analysis of the microbial dynamics involved in peri-implant health, peri-implant mucositis, and peri-implantitis.
This review explores how the peri-implant microbiome differs from the periodontal microbiome, emphasizing that peri-implant tissues present unique anatomical and immunological characteristics.
Unlike natural teeth, implants lack periodontal ligament fibers and have different vascularization patterns, which may influence microbial colonization and host response.
These structural differences can create a more susceptible environment for dysbiosis and accelerated inflammatory breakdown.
A key focus of the article is the transition from symbiosis to dysbiosis.
In peri-implant health, the microbiome is typically dominated by Gram-positive facultative bacteria associated with periodontal stability.
However, as inflammation develops, there is a progressive shift toward a more complex and anaerobic microbial profile, including Gram-negative species commonly linked to periodontal disease. Interestingly, the review also discusses emerging evidence suggesting that peri-implantitis may harbor distinct microbial signatures rather than simply replicating periodontitis-associated biofilms.
Advanced molecular diagnostic techniques—such as 16S rRNA gene sequencing and metagenomic analysis—have significantly expanded our understanding of peri-implant microbial ecology.
The authors highlight how these technologies reveal a broader and more diverse microbial spectrum than conventional culture methods, including opportunistic and non-traditional pathogens that may contribute to peri-implant breakdown.
Importantly, the review underlines the multifactorial nature of peri-implant disease.
Microbial composition interacts with host immune response, implant surface characteristics, prosthetic design, systemic conditions, and maintenance protocols.
Therefore, prevention and management strategies must go beyond mechanical debridement alone, incorporating risk assessment, supportive peri-implant therapy, and individualized maintenance programs.
For clinicians and researchers in implantology, periodontology, and oral microbiology, this article provides valuable insight into the biological mechanisms underlying peri-implant health and disease.
Understanding microbial shifts is not only essential for early diagnosis but also for the development of targeted therapeutic strategies and preventive protocols.
📖 We invite you to read the full article in PDF format on the MDPI website to explore the complete analysis, microbial profiles, and referenced scientific evidence supporting this comprehensive review.
