Role of oral yeasts in the etiopathogenesis of peri-implantitis: An evidence-based literature review of clinical studies

Objective: The aim of the present study was to review original clinical studies published in indexed databases, which assessed the role of oral yeasts in the etiopathogenesis of peri-implantitis. Design: The focused question was “Do oral yeasts play a role in the etiopathogenesis of peri-implantitis?”. Indexed databases were searched up to and including November 2019 using different combinations of the following key indexing terms: alveolar bone loss; candida, dental implant, oral; probing depth, peri-implant mucositis; peri-implantitis; and yeast. Original clinical studies were included. Studies performed on animal models, letters to the Editor, in-vivo/in-vitro/ex-vivo studies, commentaries, case-reports/series and historic reviews were excluded. The pattern of the present review article was customized to summarize the pertinent information. Results: The initial search yielded 69 studies. Sixty-two studies, which did not fit the eligibility criteria were excluded. Seven studies were included and processed for data extraction. In all studies, oral yeasts were identified in conjunction with pathogenic bacteria in the oral biofilm samples collected from patients with peri-implantitis. In 1 study on type-2 diabetic and non-diabetic patients with peri-implantitis, the counts of oral yeasts were significantly higher in type-2 diabetic and systemically healthy patients with peri-implantitis than individuals without peri-implantitis. A prior sample-size estimation was performed in 3 of the 7 included studies. Conclusion: There is no direct evidence to confirm that oral yeasts contribute towards the etiopathogenesis of peri-implantitis.