Biomedical Engineering Reference
In-Depth Information
The results reported above were then compared with asymptomatic and symp-
tomatic biofilms from dental implants. Peri-implantitis is a serious infection of dental
implants with incidence rates of up to 30% and may cause peri-implant bone loss and
implant failure. As for the rhythm management devices the biofilms from asymp-
tomatic implants had a broad diversity between patients. No obvious pathogen could
be found. From 10 patients with peri-implantitis, the sulcus fluid of the infected
implants and if available those of healthy implants and residual teeth were sampled.
From the biofilm communities more than 60 different species could be identified
revealing a large diversity of bacteria involved in peri-implantitis. Contrary to the
rhythm management devices no clear pathogen was found common to most of the
infections. The finding of very diverse microbial communities in peri-implantitis
points to a breakdown of the barrier function of the gingiva causing the disease.
Tipping the balance in favor to epithelial cells in their “race to the surface” against
bacterial cells may be here one promising approach.
The conclusion of these studies is that there is not one type of biofilm but many
as there is not one biofilm pathogen but many. Tailoring implants to the specific
biofilm communities expected at the implantation sites seems to be the best way to
control implant related biofilm infections. Furthermore, the results point to a strong
influence of the host on biofilm communities and it can be speculated that implant
material specific to the needs of the individual patient may also be an option in the
future.
Acknowledgments
The excellent technical assistance of several members of the research group
Chemical Microbiology is gratefully acknowledged. I thankMaximilian Pichlmaier (formerlyMed-
ical School Hannover, now University Hospital Munich, Germany) and Meike Stiesch (Medical
School Hannover) for contributing the clinical samples and patient data to this study. Parts of the
study have been supported by the German Research Foundation (DFG-SFB Collaborative Research
Center 599).
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