Implant And Other Prosthesis
Related Microflora Changes

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.i...
Contents
Introduction
Microbial colonization of the mouth
Microbiota around stable implants
Microbiota around failing impl...
Introduction
Microorganisms are continuously
introduced into the oral cavity.
Grouping of organisms at sites in which
they...
Introduction
As more species become established ,
the opportunity for new species
becomes limited and a degree of
stabilit...
Microbial Colonization
of
the Mouth

www.indiandentalacademy.com
Gram +ve cocci & rods
.o
S

li s
ra

cros
i
P.m
e
seria
c
eren
g

A. naeslundii
A.

Gram -ve anaerobic rods (13%)

www.ind...
Microbial colonization of the mouth

Decreased Cocci and increased No. of Motile Rods And Spirochetes
www.indiandentalacad...
Microbial colonization of the mouth
Porphyromonas Gingivalis,
A.actinomycetemcomitans
Bacteroides Forsythus,
And
Species O...
Microbial colonization of the mouth
Other bacteria associated with
periodontal destruction include:
– Fusobacterium nuclea...
Microbial colonization of the mouth
Following full mouth tooth extraction,
changes occur in the tissues and / or
surfaces ...
Microbial colonization of the mouth
Within a month after full mouth tooth
extraction, suggesting that their primary
habita...
Microbial colonization of the mouth
Streptococcus sanguis occurs in
edentulous adults with or without
conventional removab...
Microbiota Around Stable Implants

www.indiandentalacademy.com
Microbiota of Stable Implants
Gram Positive
Facultative Cocci
Non Motile Rods

S sanguis and S mitis are the most predomin...
Microbiota of Stable Implants
INFREQUENT
Motile Rods
Spirochetes,
Fusiforms &
Filaments

A actinomycetemcomitansnigrescens...
Microbiota of Stable Implants
The microflora that is present in the oral
cavity before implant placement
determines the co...
Microbiota Around Failing
Implants

www.indiandentalacademy.com
B.forsythus
P. gingivalis
P. intermedia
Spirochetes
Gram negative
anaerobic rods

www.indiandentalacademy.com

P intermedi...
Microbiota of Failing Implants
Presence of periodontal pathogens

Development of Peri-implantitis
Presence of other co-fac...
Microbiota of Failing Implants
It seems realistic to conclude that it is
possible to place implants with
acceptable rates ...
Effect of Mucosal Clinical Variables
and Peri-implant Bone Level

www.indiandentalacademy.com
Effect of Mucosal Clinical Variables
and Peri-implant Bone Level
Plaque Index,
Bleeding Index,
Gingival Index,
Probing Poc...
Effect of Mucosal Clinical Variables
and Peri-implant Bone Level
Few studies have reported on the
microbiota of implants w...
Effect of Mucosal Clinical Variables
and Peri-implant Bone Level
Local circumstances ( oral hygiene,
bone defects, deep po...
Effect of Mucosal Clinical Variables
and Peri-implant Bone Level
Hypothesis postulated
Microorganisms act as promoters or
...
Other Prosthesis Related
Microflora Changes

www.indiandentalacademy.com
C. albicans most frequent (62.1% )

Gram-positive cocci
C. albicans, C. glabrata and C. tropicalis

www.indiandentalacadem...
Other Prosthesis Related Changes
Plaque Index And The Frequency Of Yeasts
Patients With
Prosthetic Stomatitis

Higher

Pat...
Other Prosthesis Related Changes
Staph. aureus

S sanguis
S mutans
Lactobacilli
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Cocci

Filamentous

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Motile Forms

Spirochetes

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Stable Implants

S sanguis and S mitis MOST
PREDOMINANT
P intermedia and P nigrescens are
more common
Gram Positive Facult...
Conclusion
The microflora of the oral cavity prior to
implantation determines the
composition of the flora in the periimpl...
Conclusion
microflora of peri-implantitis lesions
resembles that of adult or refractory
periodontitis.
Potential pathogens...
Conclusion
Various prosthesis may provide means
of mechanical attachment to the
microflora.
This in turn allows their aggr...
References
Microbiota around root form endosseous implants: a review
of literature
Int j Oral Maxillofac Implants 2002; 17...
References
Denture plaque- past and recent concerns.
J Dent.1998;26(4):299-304.
Are certain oral pathogens part of normal ...
Thank You
www.indiandentalacademy.com
Leader in continuing dental education

www.indiandentalacademy.com
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Dental Implant microflora /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

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Dental Implant microflora /certified fixed orthodontic courses by Indian dental academy

  1. 1. Implant And Other Prosthesis Related Microflora Changes INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Contents Introduction Microbial colonization of the mouth Microbiota around stable implants Microbiota around failing implants Effect of mucosal clinical variables and bone level on microflora Other prosthesis related microflora changes Conclusion References www.indiandentalacademy.com
  3. 3. Introduction Microorganisms are continuously introduced into the oral cavity. Grouping of organisms at sites in which they can flourish and establishment in different niches. www.indiandentalacademy.com
  4. 4. Introduction As more species become established , the opportunity for new species becomes limited and a degree of stability may be attained. Upon the insertion of prosthesis this stability may be disrupted. www.indiandentalacademy.com
  5. 5. Microbial Colonization of the Mouth www.indiandentalacademy.com
  6. 6. Gram +ve cocci & rods .o S li s ra cros i P.m e seria c eren g A. naeslundii A. Gram -ve anaerobic rods (13%) www.indiandentalacademy.com
  7. 7. Microbial colonization of the mouth Decreased Cocci and increased No. of Motile Rods And Spirochetes www.indiandentalacademy.com
  8. 8. Microbial colonization of the mouth Porphyromonas Gingivalis, A.actinomycetemcomitans Bacteroides Forsythus, And Species Of Prevotella, Fusobacterium, Campylobacter & Treponema Have Been Detected www.indiandentalacademy.com
  9. 9. Microbial colonization of the mouth Other bacteria associated with periodontal destruction include: – Fusobacterium nucleatum – Campylobacter rectus – P micros – Treponema denticola – Treponema vincentii www.indiandentalacademy.com
  10. 10. Microbial colonization of the mouth Following full mouth tooth extraction, changes occur in the tissues and / or surfaces that are available for microorganism adherence. When patients with severe periodontits become edentulous, A actinomycetemcomitans and P gingivalis are no longer detectable www.indiandentalacademy.com
  11. 11. Microbial colonization of the mouth Within a month after full mouth tooth extraction, suggesting that their primary habitat is the dentition or the periodontal sulcus. Furthermore, a marked reduction or even elimination of Spirochetes, as well as a reduction in Lactobacilli, yeasts , Streptococcus mutans, and www.indiandentalacademy.com
  12. 12. Microbial colonization of the mouth Streptococcus sanguis occurs in edentulous adults with or without conventional removable dentures compared to dentate patients. Seems that no significant periodontopathic flora capable of constituting a risk factor for implants,is left after full mouth extraction. www.indiandentalacademy.com
  13. 13. Microbiota Around Stable Implants www.indiandentalacademy.com
  14. 14. Microbiota of Stable Implants Gram Positive Facultative Cocci Non Motile Rods S sanguis and S mitis are the most predominant organisms www.indiandentalacademy.com
  15. 15. Microbiota of Stable Implants INFREQUENT Motile Rods Spirochetes, Fusiforms & Filaments A actinomycetemcomitansnigrescens are  seldom detected P intermedia and P & P gingivalis more common www.indiandentalacademy.com
  16. 16. Microbiota of Stable Implants The microflora that is present in the oral cavity before implant placement determines the composition of the newly establishing microflora around implants. Implants with signs of deterioration show a microbiota resembling that of adult or refractory periodontitis. www.indiandentalacademy.com
  17. 17. Microbiota Around Failing Implants www.indiandentalacademy.com
  18. 18. B.forsythus P. gingivalis P. intermedia Spirochetes Gram negative anaerobic rods www.indiandentalacademy.com P intermedia P.micros Fusobacteria C.rectus
  19. 19. Microbiota of Failing Implants Presence of periodontal pathogens Development of Peri-implantitis Presence of other co-factors is required as well. Local or systemic circumstances are needed www.indiandentalacademy.com
  20. 20. Microbiota of Failing Implants It seems realistic to conclude that it is possible to place implants with acceptable rates in periodontal patients as long as the number of potential periodontal pathogens is kept at a low level and co-factors are in normal limits. www.indiandentalacademy.com
  21. 21. Effect of Mucosal Clinical Variables and Peri-implant Bone Level www.indiandentalacademy.com
  22. 22. Effect of Mucosal Clinical Variables and Peri-implant Bone Level Plaque Index, Bleeding Index, Gingival Index, Probing Pocket Depth Probing Pocket Depth www.indiandentalacademy.com
  23. 23. Effect of Mucosal Clinical Variables and Peri-implant Bone Level Few studies have reported on the microbiota of implants with peri-implant bone defects. -could not be related specifically to the presence of certain microorganisms, but certain microorganisms were detectable or present at higher levels in perimplant bone defects www.indiandentalacademy.com
  24. 24. Effect of Mucosal Clinical Variables and Peri-implant Bone Level Local circumstances ( oral hygiene, bone defects, deep pockets, overload) as well as systemic conditions (diabetes, smoking, genetic factors) maybe contributing factors. www.indiandentalacademy.com
  25. 25. Effect of Mucosal Clinical Variables and Peri-implant Bone Level Hypothesis postulated Microorganisms act as promoters or catalysts in implant failure, but they need a suitable environment. www.indiandentalacademy.com
  26. 26. Other Prosthesis Related Microflora Changes www.indiandentalacademy.com
  27. 27. C. albicans most frequent (62.1% ) Gram-positive cocci C. albicans, C. glabrata and C. tropicalis www.indiandentalacademy.com
  28. 28. Other Prosthesis Related Changes Plaque Index And The Frequency Of Yeasts Patients With Prosthetic Stomatitis Higher Patients Without Prosthetic Stomatitis Lower Candida albicans was 10 times higher in DIS patients www.indiandentalacademy.com
  29. 29. Other Prosthesis Related Changes Staph. aureus S sanguis S mutans Lactobacilli www.indiandentalacademy.com
  30. 30. Cocci Filamentous www.indiandentalacademy.com
  31. 31. Motile Forms Spirochetes www.indiandentalacademy.com
  32. 32. Stable Implants S sanguis and S mitis MOST PREDOMINANT P intermedia and P nigrescens are more common Gram Positive Facultative Cocci Non Motile Rods INFREQUENT Motile Rods Spirochetes, Fusiforms & Filaments; A actinomycetemcomitans & P gingivalis  seldom detected Failing Implants P intermedia, Fusobacteria and spirochetes P micros, P intermedia, C rectus, species www.indiandentalacademy.com
  33. 33. Conclusion The microflora of the oral cavity prior to implantation determines the composition of the flora in the periimplant area. The microflora around stable implants resembles that of the subgingival flora of healthy dentate patients. www.indiandentalacademy.com
  34. 34. Conclusion microflora of peri-implantitis lesions resembles that of adult or refractory periodontitis. Potential pathogens present in the oral cavity do not necessarily act as periimplant pathogens www.indiandentalacademy.com
  35. 35. Conclusion Various prosthesis may provide means of mechanical attachment to the microflora. This in turn allows their aggregation and colonization Bielby’s layer or providing smooth polished surfaces may reduce microbial colonization. www.indiandentalacademy.com
  36. 36. References Microbiota around root form endosseous implants: a review of literature Int j Oral Maxillofac Implants 2002; 17:829-38 The oral microbiota of man from birth to senility. J Periodontol 1971;42:485-96 Short term effect of full mouth extraction on periodontal pathogens colonizing the oral mucous membranes. J Clin Periodontol 1994;21:484-89 Development of dental plaque on epoxy resin crowns in man. A light and electron microscopic study. J Periodontol.1975;46:10-26 Bacterial involvement in denture induced stomatitis. J Dent Res 1988 ;67(9):1246-50 www.indiandentalacademy.com
  37. 37. References Denture plaque- past and recent concerns. J Dent.1998;26(4):299-304. Are certain oral pathogens part of normal oral flora in denture wearing edentulous subjects? Oral-Microbiol-Immunol.1991;6(2):119-22 Cultivable microflora of plaque from full denture bases and adjacent palatal mucosa. J-Biol-Buccale.1985;13(3)227-36 www.indiandentalacademy.com
  38. 38. Thank You www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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