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ePaper created 2016-03-07, 22:38:59 | version 1.38.0
12 Volume 2 | Issue 1/2016 Journal of Oral Science & Rehabilitation S ta ph yloc oc c us a ureus and pe r i i mplant di se ase ment nor universallyacceptedtreatment for peri- implantitis. The treatment of infected implants is difficult and usually requires removal.18 However, it has become clear that therapy of periimplant mucositis should be considered a preventive measure forthe onset of periimplantitis. Comple- tion of active periodontal therapy should precede implant placement in periodontally compromised patients.19 S. aureus is a facultative coccus and Gram-posi- tivebacteriumnormallyassociatedwithsurgical wounds in orthopedic patients.20 Part ofthis can be explained bythe impedance seen on cultured osteoblasts, with S. aureus surviving up to 48 h after internalization by those bone cells and still eliciting interleukin 6 and interleukin 8 res- ponses,21 which have pro-inflammatory effects andareinvolvedinosteoclastogenesis22 andfor- eign body reactions.23 In addition, S. aureus has the ability to form a biofilm and lead to chronic infection.24 Aretrospectivestudyhasdemonstratedthat patients capable of maintaining high immuno- globulin G antibody titers to S. aureus had suc- cessful implants compared with nonosseointe- gratedfixtures.25 In the present study, the lack of significance regarding the bacterial counts of S. aureus at IIP and PISF must be considered, since in vitro this pathogenhasshownanaffinityfortitaniumsur- faces,26 andtwo studies have related its levelsto deepperiimplantpocketswithbleedingonprob- ing.27, 25 One study has demonstrated that the bacterialcountsofS. aureusincreasefrom5%to 15% at implant sites 12 weeks after surgery.28 However, another study pointed out that even after seven years of follow-up the presence of S. aureus at tooth sites could be indicative ofthe presence of the same pathogen at implant sites,25 while another study indicated that the lack of S. aureus at implant sites after 12 weeks demonstrated a high negative predictive value after 12 months.29 More recently, an article demonstrated that regardless of health status, periodontal and periimplant sites harbored S. aureus cells, being the highest load of all six speciesanalyzed.30 Conclusion Withinthelimitsofthisstudy,S. aureuscouldnot be quantified inside and around dental implants in detectable limits. However, clinicians must bear in mind that, in the early stage of healing, this pathogen can influence the immune re- sponseandleadtoperiimplantboneloss. Competinginterests The study was supported by Sweden & Martina (DueCarrare,Italy),whichpaidforthekits,andby the Institut Clinident, which performed the analysis free of charge. The authors declare that they have no competing interests related to this study. Acknowledgments Theauthorshighlyappreciatetheskillsandcom- mitment of Dr. Audrenn Gautier in the supervi- sion of the study. Additionally, the authors wish tooffertheirgratitudetotheInstitutClinidentfor their professional support in the microbiological analysis.