Clinical association ofSpirochaetesandSynergisteteswith peri-implantitis

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The microbial composition of peri-implantitis-associated biofilms may resemble that of periodontitis, with some distinctive differences, as identified by various conventional or molecular detection methods. Yet, the complete microbiome of peri-implantitis awaits further characterization. The present clinical study was undertaken with the aim to investigate the association of Spirochaetes, and the more recently identified phylum Synergistetes, with peri-implantitis.

Materials and Methods:

Submucosal biofilms were obtained from single sites of patients with peri-implantitis (n = 43) or individuals with peri-implant health (n = 41). The samples were analysed by fluorescence in situ hybridization (FISH) and epifluorescence microscopy, using 16S rRNA-based oligonucleotide probes for Synergistetes cluster A, subclusters A1 and A2, and Treponema groups I–III and IV.


Treponema group IV was barely detectable, whereas Treponema groups I–III were detected at low prevalence in health, but their prevalence and numbers were significantly increased in peri-implantitis by 48% and 2.4-log, respectively. Synergistetes cluster A was detected in half of the healthy sites, and its prevalence and numbers were significantly increased in peri-implantitis by 30% and 2.5-log, respectively. No quantitative differences were found between Synergistetes subclusters A1 and A2 numbers, as both increased by 2.8-log. Synergistetes cluster A displayed strong correlations with several clinical peri-implant parameters, but Treponema groups I–III only with probing pocket depth.


The present clinical cross-sectional study demonstrates that Spriochaetes of the Treponema groups I–III, but not group IV, and Synergistetes of the cluster A are highly associated with peri-implantitis. Synergistetes cluster A appears to display a stronger association with peri-implantitis than Spirochaetes.

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