Periodontics · patient case question
Which organisms predominate in peri-implantitis?
Patient case: Deep pockets and a rising HbA1c
demo: 49-year-old female
chief: Bleeding gums and bad taste; she has noticed her front teeth are drifting.
history: Type 2 diabetes for eight years, most recent HbA1c 8.9 percent. Smokes half a pack a day. An implant placed at site 30 two years ago has recently begun to feel tender.
meds: Metformin, estradiol.
findings: Generalised probing depths of 5 to 6 mm with bleeding on probing at 62 percent of sites and no acute symptoms. Radiographs show generalised horizontal bone loss and saucer-shaped bone loss around the implant at 30 with bleeding and suppuration on probing.
Show answer and explanation
Correct answer: D. Anaerobic gram-negative organisms similar to those in periodontitis
- A. Candida may be recovered from some peri-implantitis lesions but is not the predominant organism.
- B. Lactobacilli are acidogenic organisms of the caries process and are not central to peri-implant disease.
- C. Gram-positive aerobic cocci characterise healthy peri-implant tissue, not disease.
- D. Correct. The peri-implant microbiota closely mirrors that of periodontitis, dominated by anaerobic gram-negative species. This is why a patient with untreated periodontitis carries a substantially raised risk of peri-implantitis; the pathogens translocate from teeth to implant surfaces.