The microbiota of the peri-implant region in health and disease.

The subgingival microflora associated with dental implants has been shown to be similar to that associated with natural teeth. Like the natural tooth, a dental implant may be susceptible to a plaque-induced gingivitis which may progress to peri-implantitis. A similarity exists between the microbial flora around failing implants and organisms classically associated with periodontal disease. The same anaerobic gram-negative organisms are found in periodontitis and peri-implantitis. The periodontium must be in a healthy state before the placement of dental implants and constantly monitored while implants are in function for early detection of potential periodontal and/or prosthodontic problems. The relationship between the microbial flora around dental implants and peri-implantitis is discussed and recommendations are presented to improve the efficacy of dental implants.