The role of intra-implant microbial flora in development of early implant exposure during osseointegratin

Abstract

Introduction. The peri-implant bone loss as well as early implants exposure are widely discussed themes in the literature. Different causes of dehiscences are described, like: gingival phenotype, surgical trauma, platform level bone loss, food pressure. Purpose. Evaluation of early implant exposure frequency, around implants with antibiotic treaded and non-treated platforms. The comparison of obtained data and determination of intra-implant space bacteria upon dehiscence appearance. Material and methods. From 491 implants conventionally installed in 214 patients, 254 were installed with saline solution platform wash (control group). In other 237, beside saline solution wash, an ointment „Levomekol”(with chloramphenicol as main active substance) was introduced into the intra-implantat space (study group, Figure 1), before the cover screw threading. Results. When evaluating the frequency of exposure for the number of implants, it was found that in the study group out of the total number of 237 implants exposures (according to Tal H. classification) were found in the 23 (9.7% 95%CI [5.9-13.5]) implants, 18 of them (7.6%; 95%CI [4.2-11.0]) – in the form of a fistula, and 5 (2.1%; 95%CI [0.3- 3.9]) – in the form of a dehiscence (Figure 2). In the control group out of the total number of 254 implants exposures were found at 81 implants (31.9%; 95%CI [26.2- 37.6] of which in the form of a fistula – 58 (22.8%; 95%CI [17.7- 28.0]), in the form of a dehiscence – 23 (9.1%; 95%CI [5.5-12.6]). Conclusions. The cause of early implants exposure is the inflammatory process that develops as a result of the microbial contamination of the intra-implantation space at the first surgical step. The application of antimicrobial drugs may significantly decrease the frequency of dehiscence as well as bone loss.