Quantitative assessment of Candida albicans, Staphylococcus aureus and Staphylococcus epidermidis in peri-implant health and disease: correlation with clinical parameters

<b>Introduction</b>. Peri-implantitis poses a significant challenge in oral health due to its complex microbial profile and biofilm-related persistence, complicating both prevention and treatment strategies.<b>Hypothesis/Gap Statement</b>. We hypothesized that biofilm formation by <i>Candida albicans</i>, <i>Staphylococcus aureus</i> and <i>Staphylococcus epidermidis</i> plays a critical role in peri-implantitis by inducing an inflammatory response, contributing to bone loss and implant failure. This study aimed to investigate the presence and quantify <i>C. albicans</i>, <i>S. aureus</i> and <i>S. epidermidis</i> in health and peri-implantitis using quantitative real-time PCR, enhancing our understanding of their roles in peri-implant disease.<b>Aim:</b> To explore the microbial burden of <i>C. albicans</i>, <i>S. aureus</i>, and <i>S. epidermidis</i> in peri-implantitis and healthy conditions, correlating these findings with clinical parameters.<b>Methodology</b>. In this cross-sectional study, 102 patients were recruited from the Department of Periodontology and Implant Biology at Aristotle University, Greece. Participants were divided into healthy/mucositis and peri-implantitis groups. Clinical parameters such as probing depth, clinical attachment levels and bleeding on probing were recorded, and microbiological samples were collected and analysed using real-time PCR, targeting specific genes for the pathogens.<b>Results</b>. Results showed that <i>C. albicans</i> was detected in 3.92 and <i>S. aureus</i> in 9.82% of samples, while <i>S. epidermidis</i> was present in all samples, with significantly higher loads in the peri-implantitis group (404.75 copies µl^-1) compared to the healthy/mucositis group (173.04 copies µl^-1, <i>P</i><0.001). Higher concentrations of <i>S. epidermidis</i> correlated with increased probing depth, clinical attachment levels and bleeding on probing.<b>Conclusions</b>. The research strongly emphasizes the notable connection between <i>S. epidermidis</i> and peri-implantitis, indicating its potential impact on the development and progression of the condition. These findings underscore the significance of considering the quantity of <i>S. epidermidis</i> in clinical research aimed at effectively managing patients with peri-implant diseases.