Peri-implantitis: Associated microbiota and treatment

INTRODUCTION: Peri-implantitis is a late complication of dental implant treatment, induced by microbiological changes. Since the disorder is frequent, a review is indicated of the microorganisms that influence it and of the existing treatment options. OBJECTIVE: To conduct a literature review of the microbiota associated to peri-implantitis and the existing treatment options. MATERIAL AND METHOD: A PubMed literature search was made of the studies on the microbiota associated to dental implants in healthy patients and patients with peri-implantitis, as well as of the latest treatment developments, using the following key words: "peri-implantitis AND microbiota", "periimplantitis AND microbiota", "peri-implantitis AND treatment", and "periimplantitis AND treatment". Only clinical studies in humans were considered. The following criteria were applied for including articles in the analysis: a) for the peri-implant microbiota, the search limits were human studies after the year 2000; and b) for the treatment of peri-implantitis, the search limits were randomized and controlled clinical trials (RCTs) in humans, with a minimum follow-up of 4 months, and publication after the year 2000. RESULTS: A total of 18 articles were selected in relation to peri-implant microbiota, and 13 in relation to the treatment of peri-implantitis (8 involving nonsurgical mechanical treatments and 5 surgical procedures). CONCLUSIONS: Evaluation of the literature has shown the microbiota associated to peri-implantitis to be more complex than that found under healthy peri-implant conditions - the main flora consisting of anaerobic gramnegative bacteria. No clear criteria have been identified for the diagnosis and treatment of peri-implantitis.