Comparative microbiological characteristics of failing implants and periodontally diseased teeth.
BACKGROUND
The purpose of this report was to compare the distribution of periodontal pathogens recovered from failing implants and teeth with adult and recurrent forms of periodontitis.


METHODS
A total of 41 consecutive microbial samples from patients with failing implants (IMP) were received at the Microbiology Testing Laboratory (MTL) of the University of Pennsylvania over a 2-year period. Paired control samples were selected from samples received concurrently by MTL from 41 patients with a diagnosis of adult periodontitis (AP) and 41 with a diagnosis of recurrent or refractory periodontitis (RP). Patients' mean ages for the 3 categories were 59, 47, and 53 years, respectively. Samples were collected with paper points or scalers and shipped in prereduced medium by express mail to the laboratory where they were processed within 48 hours from the time of collection. Culture was used for detection of A. actinomycetemcomitans, C. rectus, P. intermedia/nigrescens, E. corrodens, P. micros, Capnocytophaga and Fusobacterium sp., enteric Gram-negative rods, Enterococcus and Staphylococcus sp., and yeast. P. gingivalis and B. forsythus were detected by indirect immunofluorescence. Morphotypes were enumerated by dark-field microscopy.


RESULTS
The most frequently detected microorganisms from IMP were B. forsythus (59%), spirochetes (54%), Fusobacterium (41%), P. micros (39%), and P. gingivalis (27%). Recovery levels (mean +/- SD) were 1+/-1, 4+/-5, 4+/-5, 9+/-11, 1+/-2, respectively. The most frequently detected organisms for AP were B. forsythus (83%), Fusobacterium (80%), spirochetes (79%), P. gingivalis (59%), P. micros (51%), and E. corrodens (37%), at levels 2+/-2, 5+/-4, 9+/-6, 4+/-5, and 6+/-7, respectively. Corresponding data for RP were B. forsythus (85%), Fusobacterium (83%), P. gingivalis (60%), spirochetes (59%), C. rectus (56%), and P. micros (56%), at levels of 3+/-2, 8+/-8, 4+/-4, 2+/-2, 1+/-1, and 9+/-10, respectively.


CONCLUSIONS
These results indicate that the detection frequency and levels of recovery of some periodontal pathogens in failing implants are significantly different from that of teeth with periodontitis; however, the detection frequency and levels of recovery are similar in teeth affected by adult and refractory (recurrent) forms of periodontitis.
D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D000704:Analysis of Variance; D002167:Campylobacter / Q000302:isolation & purification; D002175:Candida / Q000302:isolation & purification; D002206:Capnocytophaga / Q000302:isolation & purification; D015169:Colony Count, Microbial; D003758:Dental Implantation, Endosseous; D015921:Dental Implants / Q000382:microbiology*; D003773:Dental Plaque / Q000382:microbiology; D019232:Dental Restoration Failure; D016124:Eikenella corrodens / Q000302:isolation & purification; D005260:Female; D005455:Fluorescent Antibody Technique; D005673:Fusobacterium / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010462:Peptostreptococcus / Q000302:isolation & purification; D010518:Periodontitis / Q000382:microbiology*; D018713:Prevotella intermedia / Q000302:isolation & purification; D016459:Prosthesis-Related Infections / Q000382:microbiology; D012008:Recurrence; D013144:Spirochaetales / Q000302:isolation & purification; D013210:Staphylococcus / Q000302:isolation & purification; D018709:Statistics, Nonparametric