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Volume 2 | Issue 1/2016 09 Journal of Oral Science & Rehabilitation S ta ph ylo co ccu s au re u s and pe r i i mplant di se ase Introduction Dental implantology is a central part of modern dentistry concerned with the replacement of missingteeth invarious clinical situations. Inthe past 30 years, the materials and methods of im- plant dentistry have undergone a substantial process of development and evolution. Implant surface, macrodesign and type of implant– abutment connection have been found to be of major relevance to initial healing and long-term stability.1–3 Sincethe numberofimplants placed hasincreasedinthelasttenyears,optimalmain- tenance has become increasingly important.4, 5 While in many cases, it has been reported that dental implants are a safe and predictable treat- ment method with high survival rates, they are not immunefrom biological and iatrogenic com- plications associated with improper treatment planning, surgical and prosthetic execution, or material failure, as well as maintenance prob- lems.5 Also, the biological complications of peri- implant mucositis and periimplantitis, which mayresult in soft- and hard-tissue defects, have been suggested to be relevant for later marginal boneloss.6 Several approaches have been followed in seeking to understand the pathomechanism of periimplantitis. According to a consensus con- ference of the American Academy of Periodon- tology, bacterial colonization of the implant sur- faceandtheoccurrenceofbonelossindicatethe pointofnoreturninperiimplantitis.7 Periimplan- titis is characterized byan inflammatoryprocess around an implantthat includes both soft-tissue inflammation and progressive loss of periim- plant supporting bone. Periimplantitis occurs primarily as a result of overwhelming periodon- tal insult and subsequent immune response.7 The connection to periodontitis as an infectious disease with comparable symptoms and out- comes suggests that investigating the associ- atedlocalbacteriaisfundamentaltoestablishing thepathomechanismofperiimplantitis. The implant surface may be colonized with different pathogens other than periodontal bac- teria.8 According toAlbertini et al., opportunistic pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus (S. aureus) and Candida albicansmaybeassociatedwithimplantfailure.9 As suggested in an American Academy of Periodontology report, secondary diagnostic measures, that is, bacterial culturing, inflamma- tory markers and genetic factors, may be useful in the diagnosis of periimplant disease.7 Accord- ing to Canullo et al., bacterial agglomerates around dental implants and their prosthodontic adjacent structures have been identified.10 These results suggested that all of the connec- tionswerecontaminatedafterfiveyearsoffunc- tional loading;thus,the implant–abutment con- nection design might influence bacterial activity levels qualitativelyand quantitatively, especially inside the implant connection.10 Furthermore, Cosyn et al. found that intracoronal compart- ments ofscrew-retainedfixed restorationswere heavily contaminated.11 Further investigations have shown that the restorative margin is the principal pathwayfor bacterial leakage and con- tamination of abutment screws, and bacteria most likely pass from the periimplant sulcus through the implant–abutment and abutment– prosthesisinterfaces.10 With the aim of identifying the pathogens that contribute toward the development of peri- implantitis defects, different working groups have reported a cluster of bacteria, including Treponemaforsythia and S. aureus, associated withperiimplantdisease.12 ThepresenceofS. aureusasanopportunistic pathogen inthe earlystage ofactive periimplan- titis in patients has also been confirmed by Mombelli and Décaillet.13 In addition, Salvi et al. reportedthatdetectionorlackofS. aureusatim- plant sites at 12 weeks resulted in the highest positive (i.e., 80%) and negative (i.e., 90%) pre- dictivevaluesfortheincidenceofperiimplantitis, respectively.14 Moreover, Canullo et al. showed that S. aureus is present on the external and in- ternalabutmentsurfacesifthesearenotcleaned beforescrewing.15 The aim of the present study is to investigate theprevalenceofS. aureusintheoralcavityofpa- tients with active periimplantitis. This study fol- lowed the Strengthening the Reporting of Obser- vationalStudiesinEpidemiologyguidelines.16 Materials&methods Stu dy de si gn This cross-sectional study evaluated data col- lected from 51 consecutive, partially edentulous patients of both sexes, aged 18 or older (mean age of 54.2), who had been treated with a single implant-supported, cemented or screw-retained restoration functionally loaded for at least 12 Volume 2 | Issue 1/201609