PECULIARITIES OF MICROBIOCENOSIS OF PERI-IMPLANT AREA IN PERI-IMPLANTITIS COMPLICATED BY OCCLUSAL OVERLOAD
DOI:
https://doi.org/10.35220/2078-8916-2024-53-3.14Keywords:
peri-implantitis, occlusal disorders, microbiocenosis, peri-implant fluid.Abstract
Purpose of the study. To compare microbiocenosis of periimplant area in peri-implantitis, which develops against the background of normal and excessive occlusive load on the implant. Research methods. Microbiological studies were conducted for 40 persons aged 32-45 years (young age according to WHO), equally women and men. Based on clinical examination, research and control groups were formed. The research group included 30 patients who had a negative outcome of dental implantation in 1-3 years because of peri-implantitis, among whom 15 ones had the disease against the background of functional (occlusion) overload of implants, while the remaining 15 patients had acceptable occlusion. The control group consisted of 10 persons with effective prosthetics supported by intraosseous implants in 3 years. The microbiological study involved the isolation and identification of microorganisms of peri-implant area using the technique of aerobic and anaerobic cultivation. Determination of periodontal pathogenic anaerobic microorganisms was carried out using the multi-primer polymerase chain reaction (PCR) method in real time. Scientific novelty. The microbiocenosis of peri-implant areas differed significantly for healthy persons and patients with peri-implantitis. With successful implantation, it was determined a combination of Streptococcus spp. or Lactobacillus spp. in association with Staphylococcus spp., Neisseria spp., Veilonella spp. In peri-implantitis, representatives of the periodontal pathogens Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Fusobacterium nucleatum and Treponema denticola were observed in the periimplant fluid. Moreover, in patients in whom implant failure was associated with occlusal disorders, the spectrum of periodontal pathogens was expanded due to the presence of Porphyromonas endodontalis, Prevotella intermedia and Tannerella forsythia. During the development of the inflammatory and destructive process around the implants, an increase in the number of anaerobes of Peptostreptococcus spp. In the samples of peri-implant fluid of patients with peri-implantitis against the background of occlusive overload, an increase in Staphylococcus aureus, Staphylococcus pyogenus and Haemophilus spp. Microorganisms which are typical for oral microbiocenosis disorders, in particular Escherichia coli and Candida albicans, they were cultured in periimplantitis, while the number of symbiotic species Lactobacillus spp., Corynebacterium spp., Micrococcus spp., Streptococcus salivaris decreased, reaching the lowest values in cases of occlusal imbalance. Conclusions. Occlusal overload of implants should be considered as a pathogenetic factor capable of worsening the course of peri-implantitis due to the release of various inflammatory mediators, thereby creating more favorable conditions for the progression of periodontal pathogens and suppression of autochthonous microflora. Therefore, one of the leading factors in the prevention of peri-implantitis is the dynamic control of functional occlusion.
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