Anatomical, Clinical Characteristics and Microbiological Dynamics of Implant-Supported Dental Prostheses

Abstract

In recent decades, technological and biological advances in dentistry have made the restoration of edentulous areas more functional and aesthetic. Dental implants are artificial root systems that mimic the morphology and function of natural teeth, while implant-supported prostheses play a crucial role in restoring both masticatory function and aesthetic harmony.

Successful osseointegration of implants depends on the quality of the jawbone, the condition of the soft tissues, and the proper assessment of anatomical limitations. Factors such as the thickness of keratinized gingiva, the integrity of the mucosal barrier, and the gingival biotype directly influence the risk of peri-implantitis.

Clinically, implant-supported prostheses are categorized as fixed or removable. Fixed prostheses provide high aesthetics and comfort but may pose a biological risk if excess cement remains. Removable (overdenture) prostheses, on the other hand, offer adequate stability even with a limited number of implants and are more hygienic.

In the microbiological context, both healthy and pathogenic bacterial flora can develop around implants. The biofilm structure increases bacterial resistance, leading to peri-implantitis. During this process, levels of cytokines such as IL-1β, TNF-α, and IL-6 rise, enhancing osteoclast activity and causing bone resorption.

For prevention, preoperative antiseptic protocols, strict sterile techniques, and regular professional maintenance are essential. Treatment involves mechanical debridement, antimicrobial therapy, and the use of laser and photodynamic methods.

Recent research directions focus on developing bioactive surfaces coated with nanohydroxyapatite and silver ions to reduce bacterial adhesion, using probiotics to stabilize peri-implant microflora, and employing 3D printing technology to create personalized implant–prosthetic systems.