title: Microbial colonization at the implant-abutment interface and its possible influence on periimplantitis: A systematic review and meta-analysis.
abstract: OBJECTIVE
  The aim of this systematic review and meta-analysis was to evaluate the microbial colonization at the implant-abutment interfaces (IAI) on bone-level implants and to identify possible association with peri-implant conditions.
  
  
  METHODS
  The focus question aimed to answer whether two-piece osseointegrated implants, in function for at least 1 year, in human, relate to higher bacterial count and the onset of periimplantitis, compared to healthy peri-implant conditions. Search strategy encompassed the on-line (MedLine, Google scholar, Cochrane library) literature from 1990 up to March 2015 published in English using combinations of MeSH (Medical Subject Headings) and search terms. Quality assessment of selected full-text articles was performed according to the ARRIVE and CONSORT statement guidelines. For data analysis, the total bacterial count of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, and Fusobacterium nucleatum was calculated and compared to IAI with or without peri-implant pathology.
  
  
  RESULTS
  A total of 14 articles, reporting data from 1126 implants, fulfilled the inclusion criteria and subjected to quality assessment. The selected studies revealed contamination of the IAI, in patients who received two-piece implant systems. Meta-analysis indicated significant difference in total bacterial count between implants affected by periimplantitis versus healthy peri-implant tissues (0.387±0.055; 95% CI 0.279-0.496). Less bacterial counts were identified in the healthy IAI for all the investigated gram-negative bacteria except for T. forsythia.
  
  
  CONCLUSIONS
  Significantly higher bacterial counts were found for periodontal pathogenic bacteria within the IAI of implants in patients with periimplantitis compared to those implants surrounded by healthy peri-implant tissues.
authors.affiliation: Private Practice, Rome, Italy; Aldent University, Implantology and Prosthetic Aspects, Master of Science in Dentistry Program, Tirana, Albania. Electronic address: me@studiomarcotallarico.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Tallarico
authors.affiliation: Private Practice, Rome, Italy; Istituto Stomatologico Toscano, Camaiore, Viareggio, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Canullo
authors.affiliation: University of Trieste, Trieste, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Caneva
authors.affiliation: University of Zurich, Center for Dental and Oral Medicine, Dental Materials Unit, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zurich, Switzerland.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Özcan
mesh_terms: D058491:Bacterial Load; D016206:Databases, Bibliographic; D000044:Dental Abutments / Q000382:microbiology*; D059605:Dental Implant-Abutment Design; D015921:Dental Implants / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D057873:Peri-Implantitis / Q000209:etiology* / Q000382:microbiology*
chemical_list: D015921:Dental Implants
keywords: Bacterial colonization; Dental implant; Peri-implant bone loss; Periodontal pathogens; Systematic review