MICROBIAL COLONIZATION OF THE PERI-IMPLANT ENVIRONMENT AND ITS RELEVANCE TO LONG-TERM SUCCESS OF OSSEOINTEGRATED IMPLANTS

Purpose: This article provides a critical examination of the literatur e on the colonization of the peri-implant environment and its impact o n clinically significant infection, in the context of a comparison wit h the microbial etiology of periodontitis. Materials and Methods: Prev ious journal article bibliographies and MEDLINE searches provided comp rehensive access to current literature on this topic. References that provided significant or novel advancements in knowledge were included in this review. Since it was prepared for a workshop that would examin e this issue critically, this review offers provocative commentary. Re sults: There are many similarities in periimplant and periodontal micr obiology, both in health and in infection leading to progressive deter ioration. Periodontal pockets serve as reservoirs for the colonization of implants by periodontal pathogens in partially edentulous patients . Implant design and material composition affect the colonization of i mplant surfaces. Infections around implants can be treated by similar strategies used for periodontitis. investigators are beginning to adop t research designs used in periodontology to study the pathogenesis an d treatment of peri-implant infections. Research in this area is imped ed by the lack of surrogate variables for crestal bone resorption. Con clusion: Some implants fail as a result of infection, but the frequenc y of failure by infection or any other cause is unknown. This paper su ggests areas where much more additional research is needed, including critical consideration of strategies that have led to the past few dec ades' advancements in the pathogenesis of periodontitis.