Evaluation of Microlekage and the Antibiotic Sensitivity Pattern of the Organisms at the Implant Superstructure Interface - An In vivo Pilot Study
Authors: Nayak Aishwarya Gajanan , Nadiger Ramesh , Bhat Kishore , Ingalgi Preeti , Kulkarni Raghvendra , Shirhatti Ravi 
Published: December 2024

Background:
Microleakage at the implant superstructure interface can compromise the long-term success of dental implants by allowing microbial penetration, leading to peri-implant diseases. Understanding the antibiotic sensitivity patterns of the organisms present at this interface is essential for devising effective therapeutic strategies. Despite advancements in implant technology, limited research exists on the in vivo evaluation of these factors. This pilot study aims to bridge this gap by exploring the extent of microleakage and the microbial sensitivity profile, providing valuable insights for enhancing implant longevity and patient outcomes.

Aims and Objectives:
The study aimed to evaluate microlekage at the implant abutment interface and the objective was to study the antibiotic sensitivity pattern of these organisms.

Materials and Methods:
Around 20 patients were selected after a thorough investigation with lower missing teeth (1st and 2nd premolars 1st and 2nd molars) by inclusion criteria. The subjects were divided into 2 groups Group A (10 patients) – Control group and Group B (10 patients) - Test group. The implants were placed with proper surgical protocol in all the patients except that in the test group antibacterial sealant was used before putting the coverscrew. The implants were allowed to osseointegrate for 3 months after which swabs were collected from the interior of the implant once the cover screw removed. The swabs collected from all the patients were immediately transported to microbiology lab by placing in 1ml of Reduced Transport Fluid (RTF) medium. The swabs collected from all the patients were immediately transported to microbiology lab by placing in 1ml of Reduced Transport Fluid (RTF) medium. The swabs were vortexed in the RTF and 100 micro liter of RTF was spread uniformly over Brain Heart Infusion (BHI) Agar plate. Another 100 micro liter of RTF was inoculated on BHI and McKonkeys medium and processed for routine culture and sensitivity. Identification of the isolates were done by standard microbiological methods. Antibiotic sensitivity of the isolates were determined by Minimum inhibitory concentration(MIC) procedure. The data thus obtained was subjected to statistical analysis.

Results:
Porphyromonas gingivalis and Streptococcus mutans were mainly isolated from the samples. Test group showed significanlty lesser Colony Forming Units (Mean CFU 1.900) and standard deviation of 3.78 compared to control (Mean CFU 17.00) and a standard deviation of 19.03.

Conclusion:
Under the limitations of the above study it was concluded that microbial growth was present in both test as well as control groups but in the test group with an antibacterial sealant the growth was comparatively lesser. Predominant growth was that of Streptococcus mutans followed by P gingivalis. Metranidazole followed by Azithromycin was found to be effective at lower concentrations for the predominant genes of these organisms.