28 May 2023

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Impact of smoking on the peri-implant microbiota

Lara Figini

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Peri-implantitis is characterized by inflammation with destruction of the alveolar bone with increased probing depth and has been associated with poor bacterial plaque control and a history of severe periodontitis.

Similar to periodontal microorganisms in healthy gingiva, microorganisms in peri-implant tissues of healthy implants are predominantly Gram-positive cocci and rod organisms. The microbiota at the level of diseased peri-implant sites instead consists of Gram-negative anaerobes associated with periodontitis pathogens and opportunistic microorganisms and is frequently associated with non-saccharolytic Gram-positive rod anaerobes.

The data show that the detectable pathogens in periodontitis are Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia, suggesting that peri-implantitis could be a polymicrobial anaerobic infection; however, the specificity of the microbiota causing peri-implantitis still remains unclear.

Smoking is a significant risk factor for periodontitis and can affect the microbiota profile in the peri-implant tissue.

Materials and methods

In a study published in the Journal of Dentistry in April 2023, the authors evaluated the studies that ascertained the relationship between smoking and the peri-implant microbiota, with the aim of arriving at an answer to the following questions:

• Are there differences in the microbiota of healthy peri-implant tissue between smokers and non-smokers?
• Are there differences in the microbiota of diseased peri-implant tissue between smokers and non-smokers?
• Does smoking affect the transition of the microbiome from healthy to diseased state?

The authors of this review conducted an electronic literature search through the Medline/PubMed, Embase, and Scopus databases through January 2023 with no language restrictions.

Studies were considered eligible for inclusion if they evaluated the peri-implant microbiota of smokers compared with that of non-smokers. Methodological quality was assessed using the adapted Newcastle-Ottawa scale.

Results

Fourteen studies were identified for inclusion in this review and of these, 85.7% were rated as of medium-high methodological quality. The data indicated that significantly higher frequencies of anaerobic pathogens were detected in healthy peri-implant tissues of smokers. Less microbiota diversity was observed in healthy peri-implant sites of smokers.

In the transition from the clinically healthy to the diseased state, smoking shaped the peri-implant microbiota, reducing the good or commensal species and enriching the pathogenic species.

Conclusion

From the data of this review, which must be confirmed in other similar studies and reviews, it can be concluded that the composition of the peri-implant microbiota can be influenced by smoking.

For more information: "The impact of smoking on peri-implant microbiota: a systematic review."