Exploring the Oral Microbiome: Implications for Peri-Implant success" A systematic Review and Meta-analysis

Abstract

Background: The oral microbiome plays a critical role in peri-implant health and disease, influencing the long-term success of dental implants. Increasing evidence suggests that peri-implantitis is associated with a dysbiotic microbial shift characterized by depletion of health-associated commensals and enrichment of pathogenic taxa. However, the microbial differences between healthy and diseased peri-implant sites, as well as their relationship to the periodontal microbiome, remain incompletely understood.

Aim:This systematic review and meta-analysis aimed to characterize the peri-implant microbiome in health and disease and to evaluate the association between specific microbial taxa and peri-implantitis.

Methods:This review was conducted in accordance with PRISMA 2020 guidelines. Electronic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library for studies published from January 2010 to December 2023. Eligible studies included adult patients with functioning dental implants and used culture-independent molecular methods to evaluate the peri-implant microbiome. Study selection was completed by two independent reviewers. Quality assessment was performed using the CASP checklist for case-control studies. Where appropriate, meta-analysis was conducted using a fixed-effect Mantel–Haenszel model.

Results:Eighteen studies were included in the qualitative synthesis, comprising 689 patients and 1,247 implant sites. Healthy peri-implant sites were predominantly colonized by Gram-positive facultative bacteria, particularly members of Actinobacteria and Firmicutes, including Streptococcus, Actinomyces, Rothia, Veillonella, and Neisseria. In contrast, peri-implantitis sites exhibited a pathogen-enriched, commensal-depleted microbiome with increased abundance of Porphyromonas, Tannerella, Treponema, Fusobacterium, and Filifactor. The peri-implant microbiome was also shown to be distinct from the periodontal microbiome, even within the same individual. Quantitative synthesis of two eligible studies demonstrated a significant association between Porphyromonas gingivalis and peri-implantitis, with a pooled odds ratio of 3.42 (95% CI: 1.87–6.25; p < 0.001) and low heterogeneity (I² = 8.3%).

Conclusion:Peri-implant health is associated with a balanced microbiome rich in commensal taxa, whereas peri-implantitis is characterized by microbial dysbiosis and enrichment of established periodontal and emerging implant-associated pathogens. These findings highlight the importance of microbiome profiling in understanding peri-implant disease pathogenesis and may support future diagnostic and preventive strategies to improve peri-implant success