Surface-related factors affecting bacterial adhesion on dental implants: a short literature review

Dental implants offer a predictable solution for tooth replacement, yet peri-implant diseases, including peri-implant mucositis and peri-implantitis, remain a significant clinical concern and are primarily driven by bacterial biofilm formation on implant surfaces. The unique anatomy of peri-implant tissues, characterized by the absence of a periodontal ligament and distinct soft tissue attachment, increases susceptibility to microbial colonization. Bacterial adhesion is a dynamic process initiated by reversible attachment to the acquired pellicle, followed by irreversible binding via bacterial adhesins and the production of extracellular polymeric substances, leading to biofilm maturation. Implant surface topography and physicochemical properties strongly influence these processes. While rough surfaces facilitate bacterial retention by providing protective niches, polished transmucosal surfaces reduce plaque accumulation and improve cleanability. Differences in surface properties between titanium and zirconia have been reported, with zirconia showing a tendency for lower bacterial adhesion in vitro, although clinical outcomes are shaped by multiple factors beyond surface characteristics. Integrating knowledge of implant topography, material-dependent surface properties, and microbial behavior is essential for guiding implant design, minimizing biofilm formation, and promoting long-term peri-implant tissue health.