Clin Implant Dent Relat Res. 2003;5(4):226-32. doi: 10.1111/j.1708-8208.2003.tb00205.x.
Microbiologic diagnostics at titanium implants.
Clinical implant dentistry and related research
Asa Leonhardt, Christina Bergström, Ulf Lekholm
BACKGROUND: The microbiota found at periimplant lesions have been shown to contain putative periodontal pathogens as well as opportunistic species such as Staphylococcus spp, enterics, and Candida spp. Therefore, a microbiologic diagnosis may be of value as guidance before treatment of such lesions.
PURPOSE: The aim of this study was to evaluate the prevalence of some putative pathogens associated with long-term followed-up cases using two different microbiologic procedures.
MATERIALS AND METHODS: Fifteen subjects contributed with plaque samples from teeth and implants; these were analyzed with respect to 18 putative periimplant pathogens using cultural methods and a deoxyribonucleic acid DNA-DNA hybridization technique.
RESULTS: The number of individuals positive for the analyzed pathogens was similar in samples taken from teeth and implants when analyzed with the DNA-DNA hybridization technique. When comparing detection frequency by culture procedure and by "checkerboard" technique at implants, the number of individuals positive for these species was lower with the traditional culture technique than with the checkerboard analyses. Using a higher cutoff point (> or = 4) with the checkerboard technique, the number of positive individuals was generally lower than that found with the culture technique. When comparing the techniques on an implant site level, the prevalence obtained by culture was lower for all analyzed species. If the specific species were present in the samples analyzed by the checkerboard technique, they were present only in every second sample analyzed with the culture technique. The high specificity values showed that if the checkerboard technique did not detect any Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetemcomitans, or Fusobacterium nucleatum, the bacteria were also undetectable by the culture technique. The two methods therefore did not overlap but did supplement each other.
CONCLUSIONS: Based on the current results it is recommended that the technique used when analyzing microbiota around titanium implants should be a combination of the two protocols mentioned as they seem to give the most comprehensive outcome when used together.