Periodontal considerations of implants and implant associated microbiota

The scientific and clinical acceptance of the success of osseointegrated dental implants has been firmly established, but the relationships between clinical observation and periimplant pathogenesis is not well understood. Data and concepts regarding the diagnostic value of traditional periodontal evaluation parameters, such as pocket probing depth, bleeding on probing, attachment loss, gingival and plaque indices, and the amount of attached gingiva are discussed. The microbiologic characterization of plaque associated with various implant systems reveals many similarities and some differences compared to natural teeth. An hypothesis for the "periodontal" etiology of implant failure is proposed. The maintenance of edentulous and partially edentulous patients with implants is discussed.