Bacterial colonization of dental implants may be followed by chronic inflammation of peri-implant hard and soft tissues. Several studies have demonstrated that the long-term prognosis of osseointegrated implants depends on the biofilm mass and the colonizing species within the biofilm which can in-turn influence Early crestal bone loss . (Kolenbrander PE et al 2000).

The early processes of supra- and subgingival biofilm formation, such as the generation of an acquired pellicle from salivary biopolymers or enzymes and the adherence of early colonizing microorganisms, have been described together with the relationship between biofilm formation and periodontitis or peri-implantitis respectively ( Heuer W et al 2007). For example, Streptococcus or Actinomyces species are known to create the preconditions for the accumulation of Gram-negative anaerobic late-colonizing microorganisms, such as Fusobacterium or Prevotella species . These bacteria, as well as Aggregatibacter actinomycetemcomitans or Porphyromonas gingivalis, have been frequently isolated from diseased periodontal or peri-implant sites and have been designated as highly relevant for the development of chronic periodontal or peri-implant inflammatory processes.

Several studies have shown that the microbial composition shifts toward a higher proportion of periodontal pathogens during peri-implant biofilm formation. This shift, as well as the general process of biofilm formation, is affected by various factors like ecological cofactors like pocket formation, salivary composition, and nutrition and patients systemic conditions like Diabetes (Oliveira et al PG 2020) and habits like smoking (Kasat V et al 2012). The contribution of different implant design characteristics (Sathya Ramanathan et al 2020) to the accumulation of biofilms and the following clinical consequences are also discussed as one of the major influencer. (Heuer W et al 2012).

Taking into consideration that smoking and Diabetics were previously considered as

risk factors for implant failure

and also a known modifier of periodontal and peri- implant microflora qualitatively and quantitatively which can endanger the success of

dental implants causing peri-implantitis and leading to Greater Crestal Bone loss. 

NOVELTY OF THE STUDY : The proposed implant design (Laser microgrooved implants and the abutments) by itself is novel and less researched. The major criteria assessed for implants are their success rate and the crestal bone level changes post 1 year of functional loading. As implants have gained greater success rate it is the crestal bone level changes that still needs attention as most of the implant systems have early crestal bone loss due to the micro gap present between the implant and the abutment junction leading to microbial colonisation. The proposed implant design is supposed to have micro-grooving on implant collar and abutment junction which gives us a ‘cold welding” effect and reduces microgap and supposed to reduce microbial load and thereby reducing mean crestal bone loss (Sathya et al 2020). Previously the microflora of periodontal disease and peri-implantitis was considered to be the same but off late they have seen a shift in the microbial colonisation and as the full microbiome of the peri-implant sulcus sites are not evaluated much to find the significant difference so the metagenomic sequencing (Kumar et al) would help us to evaluate the same. The main important risk factors which are considered other than bacterial challenge is systemic and environmental factors thus addressing them giving this implant system would benefit the patients as a whole. Thus this study gets the novelty that it is the first to address the microbiome of diabetics, smokers and systemically healthy patients who have received laser micro-grooved implants and abutments which could address the reduction in mean crestal bone levels.