Biofilm Formation on Natural Teeth and Dental Implants: What is the Difference?

Abstract

Dental plaque is a milieu of microbes embedded within a polymeric layer of glycoproteins precipitated from the saliva onto tooth enamel, dental implants, cementum, and epithelium. This dental biofilm can extend below the gingival margin into the socket where the microorganisms are concealed from the bacteriostatic components in the saliva and the shearing forces exerted by chew- ing and normal brushing. Gingivitis and periodontal disease occurs when more virulent microbes colonize the subgingival pocket and evade eradication by the host defenses. A distinctive shift in microbial colonization is observed with the progression of disease highlighted by the expansion of gram negative and strictly anaerobic bacteria. Host response and inflammation meant to eliminate the micro- bial insult are counterproductive and generate a deeper pocket within the dental socket that permits the microbial access to the alveolar bone. Dental implants form another nidus for bacterial infection following surgery when the surface and socket are exposed to the oral environment. Dental implantation may be a direct conse- quence of periodontal disease; therefore the underlying microbial infection could threaten successful osseointegration of the implant if a microbial biofilm develops. Periodontal pockets and other oral niches, such as the mucosa and tonsils, are res- ervoirs for the microbial pathogens that initiate the inflammation of the marginal soft tissue around the dental implants that may lead to implant failure. Reduction in peri-implantitis rates are shown when patients delay implant surgery after tooth extraction and rigorous preoperative and postoperative antibiotic regiments as well as improved dental hygiene are incorporated into the post-operative treatment. L. Molly Department of Periodontics, Dental School, University of Maryland-Baltimore, 650 W. Baltimore Street , Baltimore, Maryland 21201 e-mail: lmolly@yahoo.com Springer Series on Biofilms, doi: 10.1007/7142_2008_26109 © Springer-Verlag Berlin Heidelberg 2008 109