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Epstein-Barr virus associated peri-implantitis: a split-mouth study.

Fernando Verdugo1, Ana Castillo, Francisca Castillo

  • 1Department of Periodontics, VA Hospital, Greater Los Angeles, Healthcare System, Los Angeles, CA, USA, fverdugo@perio.org.

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|May 8, 2014
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Epstein-Barr virus (EBV) is linked to peri-implantitis (PI). PI lesions are more likely to harbor EBV and specific bacteria. Saliva testing can predict bacterial infection but not viral presence in PI.

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Area of Science:

  • Oral microbiology
  • Infectious diseases
  • Periodontology

Background:

  • Peri-implantitis (PI) is a complex inflammatory condition affecting implants.
  • Herpesviral-bacterial synergism is hypothesized to contribute to periodontitis and PI.
  • Host susceptibility and specific microbial challenges influence PI lesion severity.

Purpose of the Study:

  • To investigate herpesviral-bacterial co-infection in PI patients.
  • To assess the association between PI and periodontopathogen salivary contamination.
  • To evaluate Epstein-Barr virus (EBV) and cytomegalovirus (CMV) presence in PI lesions and saliva.

Main Methods:

  • Cross-sectional, split-mouth study design.
  • PCR-based identification of EBV and CMV in PI lesions, healthy implant sites, and saliva.
  • Clinical evaluation of probing depths, bleeding on probing, and suppuration.
  • Radiographic assessment for lamina dura and bone loss.
  • Quantitative PCR for viral copy counts and odds ratio analysis.

Main Results:

  • PI lesions were significantly more likely to harbor EBV compared to healthy implants and saliva.
  • EBV demonstrated a high positive predictive value (90%) in PI lesions.
  • PI was associated with the absence of lamina dura and increased periodontopathogen levels.
  • Saliva PCR showed high agreement with bacterial detection in PI but not with EBV.
  • Specific bacteria like Treponema denticola, Tannerella forsythia, and Prevotella nigrescens were more prevalent in PI lesions and saliva.

Conclusions:

  • EBV is implicated as a potential factor in the etiopathogenesis of peri-implantitis.
  • Saliva PCR is effective for predicting bacterial infections associated with PI but not viral infections.
  • Herpesviral-bacterial interactions may drive PI progression, suggesting potential benefits from antiviral therapy for non-responsive cases.