Authors

  • Tashmuhammedova Shaxnoza
    Samarkand State Medical University, Uzbekistan
  • Sadriyev Nizom Najmiddinovich
    Samarkand State Medical University, Uzbekistan

DOI:

https://doi.org/10.71337/inlibrary.uz.eijmrms.35547

Keywords:

Implantation aerobic and anaerobic microflora peri-implantitis

Abstract

In modern conditions, mixed oral infections: pathogenic and opportunistic bacteria, fungi and protozoa are becoming increasingly important in the emergence of delayed inflammatory complications after dental implantation. Literature data shows that violations of normobiosis in all mucous membranes of the oral cavity are associated with its hygienic condition, dental and periodontal diseases. Local immune protection factors are not of minor importance. To date, the etiological role of the entire group of microorganisms in the appearance of dental mucosa and tooth fairy-implantitis has not been determined. We are talking, first of all, about fungi of the genus Candida, streptococci and staphylococci, the presence of which in the tissues of the oral cavity often indicates immunological diseases in the body, as well as anaerobes found without periodontal signs. tissue disease [2]. In this regard, under certain and not yet fully understood conditions, special attention should be paid to these infectious factors that can lead to the development of inflammatory and inflammatory-destructive complications after surgical interventions carried out to install implants. Rational and effective diagnosis of microbial infection in patients with inflammatory complications after dental implantation remains an unresolved problem, no highly effective pathogenetic methods of its elimination have been developed.


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EIJMRMS ISSN: 2750-8587

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THE ROLE OF AEROBIC AND ANAEROBIC MICROFLORA IN THE DEVELOPMENT OF

DENTAL MUCOSITIS AND DENTAL PERI-IMPLANTITIS

Tashmuhammedova Shaxnoza

Samarkand State Medical University, Uzbekistan

Sadriyev Nizom Najmiddinovich

Samarkand State Medical University, Uzbekistan

AB O U T ART I CL E

Key words:

Implantation, aerobic and anaerobic

microflora, peri-implantitis, inflammation, oral

cavity.

Received:

03.06.2024

Accepted

: 09.06.2024

Published

: 13.06.2024

Abstract:

In modern conditions, mixed oral

infections: pathogenic and opportunistic bacteria,

fungi and protozoa are becoming increasingly

important in the emergence of delayed
inflammatory

complications

after

dental

implantation. Literature data shows that

violations of normobiosis in all mucous

membranes of the oral cavity are associated with
its hygienic condition, dental and periodontal

diseases. Local immune protection factors are not

of minor importance. To date, the etiological role

of the entire group of microorganisms in the
appearance of dental mucosa and tooth fairy-

implantitis has not been determined. We are
talking, first of all, about fungi of the genus

Candida, streptococci and staphylococci, the
presence of which in the tissues of the oral cavity

often indicates immunological diseases in the

div, as well as anaerobes found without

periodontal signs. tissue disease [2]. In this
regard, under certain and not yet fully understood

conditions, special attention should be paid to

these infectious factors that can lead to the

development of inflammatory and inflammatory-

destructive

complications

after

surgical

interventions carried out to install implants.

Rational and effective diagnosis of microbial

infection in patients with inflammatory

complications after dental implantation remains
an unresolved problem, no highly effective

VOLUME04 ISSUE06

DOI:

https://doi.org/10.55640/eijmrms-04-06-07

Pages: 38-44


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pathogenetic methods of its elimination have been

developed.

INTRODUCTION

The purpose of the study is:

to identify the role of staphylococcal, fungal and anaerobic infections in

the occurrence of inflammatory complications in the delayed period after dental implantation and

develop new methodological approaches to their elimination.

Object and methods of research:

We examined 32 patients for a long time after a dental implant into

the bone, in which inflammatory complications were identified: 18 - dental mucosa and 14 - third-
degree dental fairy-implantitis. Of these, 17 (53.1%) were male and 15 (46.9%) were female between

the ages of 34 and 52. All patients were practically healthy people, without inflammatory and Infectious

Diseases of other organs and systems. At the initial stage of the study, depending on the nosological

dependence of inflammatory complications arising in the peri-implant area, patients were divided into

two groups, comparable in sex, age and number of regions involved in the pathological process. The

first group includes patients with dental mucositis; in the second - dental peri-implantitis all patients

underwent a comprehensive clinical and radiological examination using generally accepted methods in
modern conditions.

Simplified hygiene index (GreenVermillion) and bleeding index determination for objective assessment

of the condition of the tissues of the Peri-implant zone (Mühlemann H. P., Cowell F.) were used. The

depth of the Peri-implant pockets was taken into account.

Standard clinical laboratory testing includes general and biochemical blood tests, general urine

analysis, blood tests for sugar, HIV, syphilis, hepatitis B and C.

To determine the qualitative composition of bacterial agents in the Peri-implant zone, we used the
classical bacteriological research method, as well as the rapid method of polymerase chain reaction

(PZR), followed by reverse DNA hybridization. Microbiological studies were carried out on material

from the peri-implant zone after rinsing the mouth with distilled water.

In our work, we used the traditional method of processing the results of microbiological research,

including calculating the percentage of a particular species in the calculation of the content of bacteria

isolated in patients of both groups, as well as the frequency of occurrence of resistant or sensitive

strains. to antibacterial drugs under study


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RESEARCH RESULTS AND DISCUSSION

Bacteriological studies have shown that dental mucosa and dental peri-implantitis are characterized by
differences in etiological structure.

In positive cultures of material from the peri-implant zone of dental mucositis patients, aerobic

microflora was often identified (88.9%), less frequently - association with anaerobes (11.1% of cases).

In aerobic flora, gram-positive microorganisms were found 84.4%, gram-negative - 5.6%.

Among the aerobic microorganisms isolated in associations, streptostaphylococcal infection prevailed,

the proportion of which reached the maximum total values, and the proportion of other infectious

agents was not shown much. In addition, in 44.4% of cases, the formation of a 34-component
Association of opportunistic microorganisms was observed. A wide range of aerobes is represented in

decreasing order by the following bacteria: Streptococcus intermedius (94.4%), Peptostreptococcus

micros (77.8%), Staphylococcus spp. (44.4%), Enterobacter spp. (16.7%), Acinetobacter spp. (11,1%).

Anaerobic bacteria have been rarely identified in patients with dental mucositis (16.7%). In one case of

dental mucosa, periodontopathogenic microorganisms were found in the peri-implant zone:

Bacteroides forsythus, A. Actinomycetemcomitans and Porphyromonas gingivalis.

Among staphylococci isolated from patients with dental mucosa, coagulase-negative staphylococci
were rarely found. Often Staphylococcus aureus.

The data obtained makes it possible to argue that parasitocenosis of the peri-implant zone in patients

with mucous membranes is characterized by a multi-component set of possible triggers of the

inflammatory process. Obviously, the leading pathogens that begin the occurrence of this complication

after dental intraosseous implantation are streptostaphylococcal infections.

Using the molecular genetic research method, a mixed infection characterized by great diversity due to
anaerobes (in 63.3% of patients) and Gram-negative aerobic flora (in 36.7% of cases) was found in

material from the implantation pocket of patients. with dental peri-implantitis. Polyinfection is

represented by the following periodontopathogenic microorganisms: Bacteroides forsythus (55.6% of

cases), Porphyromonas gingivalis (50.0%), Fusobacterium nucleatum (44.4%), A. Actino

mycetemcomitans (38.9%), Prevotella.38.9. Their Candida spp., Enterobacter spp., The relationship of

Streptococcus intermedius, Peptostreptococcus micros and Staphylococcus aureus to the fungi of the

genus respectively 44,4%, 38,9%, 13,2%, 13,2% and was found in 28.5% of cases.


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In the available literature, we did not find similar information for patients of this category. Such a high

proportion of anaerobic substances and their variety make it difficult to identify the leading pathogenic
microorganism, which is usually called the "leader" of the infectious-inflammatory process. It can be

seen that this is the specific effect of the interaction of the most diagnosed pathogens and anaerobic

agents of parasitocinosis, which largely determine the nature of the inflammatory-destructive process

in the peri-implant zone of patients with dental peri-implantitis.

The second direction of the study consisted in assessing the sensitivity of the identified triggers of

dental mucosa and dental peri-implantitis to antibiotics that are applied parenterally in clinical practice.

We found that amicacin (100%), rovamycin (94.4%), clarithromycin (94.4%), roxithromycin (94.4%),
cefazolin (94.4%) had the highest activity compared to aerobic microflora. , ciprofloxacin (94.4%),

actinomycin (94.4%). 77.8%, gentamicin (77.8%).

Compared to anaerobic microorganisms, imipenem, coamoxiclav, ceftriaxone, and vancomycin have

universal (90% -100%) activity.

The question of choosing antimicrobial therapy in the complex treatment of dental mucosa and dental

peri-implantitis is from the point of view of the data we have received and the clinical testing of a

number of antibacterial drugs that are highly sensitive to aerobic infections and anaerobic bacteria.
does not cause difficulties. As an etiotropic therapy in patients with dental mucosa, it is recommended

to use one of the following antibiotics - Oxacillin, roxithromycin, cefazolin, clarithromycin and

ciprofloxacin, in patients with Tooth Fairy-implants - imipenem, coamoxiclav, ceftriaxone and

vancomycin.

CONCLUSION

1.

Microcinosis of periapical tissue in patients with dental mucositis and dental peri-implantitis is
characterized by a large variability in quality indicators of microorganisms.

2.

The main pathogenic and opportunistic pathogens of detailed mucositis are Gram-negative

microorganisms.

3.

The leading place in the etiology of dental periimplantitis is occupied by anaerobic bacteria, mainly

periodontal agents, often associated with candidiasis and enterobacterial infections.

4.

Isolated pathogens of the dental mucosa turned out to be sensitive to amikasin, clarithromycin,

roxithromycin, cefazolin, ciprofloxacin in 90-100% of cases. Absolute sensitivity to the microflora


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of the peri-implant zone of patients with dental peri-implantitis is manifested by imipenem,

coamoxiclav, vancomycin, ceftriaxone.

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