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This study investigates factors relating to the success and survival of patient-specific subperiosteally multivectorial anchored implants (IPS-Implant) with a minimum of two coupling elements (CE) to anchor the prosthetic restoration in challenging patient situations. Construction parameters of the implants were analyzed. Implantation timepoint, complications, and complication severity using USPHS criteria (A–D) were obtained from patients records. CE-location, spacing, length and transmucosal height were evaluated for their influence. The medial plaque (mPI) and the gingival (GI) indices were evaluated in order to assess inflammations around the CE. Success and survival rates were analyzed via Kaplan–Meier analysis and log-rank tests. In fifteen patients (6 men, 9 women) aged 40 to 92 in total 49 CE were examined. Kaplan–Meier analysis revealed a 2-year success rate of 91.6% and survival rate of 97.5%, while long-term analysis showed a success rate of 53.9% and survival rate of 89.4% after 8.9 years in total. Only 3 CE got lost due to fracture of the supporting bone. 46 CE are still in clinical use. After 1.8 years in the earliest, in 18 cases, signs for inflammation were detected. 10 of these inflammations required medical care. Subperiosteal implants show good short-term results but often face soft-tissue complications over time. Neighboring natural teeth and distances between coupling elements < 10 mm increased the risk for complications. Implant design, surface finish, and prosthetic protection are crucial for long-term success, requiring further research.

Smoking, a risk factor for periodontitis and peri-implantitis, is associated with shifts in the oral microbiome (OM) composition. Although smoking habits are almost always established before adulthood, data on effects of smoking on the OM in adolescents is rare. The aim of this study was to investigate the early impact of smoking on the OM composition in pupils. The adolescent cohort, aged 14–20, comprised 98 smokers and 98 non-smokers matched for several physiological co-variates. Buccal swabs were analysed for OM composition using high-throughput sequencing of the full-length 16 S rRNA gene targeting species-level resolution. Parameters of bacterial diversity and abundance of individual bacterial taxa were related to information on smoking. The microbiome dataset contained 733 species-level taxa. Streptococcus , Rothia , and Haemophilus dominated both groups, smokers and non-smokers. Smoking exerted a discernible influence on the overall microbial composition as measured by weighted UniFrac distances. The number of species-level bacterial taxa was significantly higher in individual smokers compared to non-smokers. Furthermore, several taxa, including known pathogens, exhibited significant differences in abundance between the two groups. The genera Veillonella , and Actinomyces , as well as and multiple Actinomyces species, Dialister invisus , Atopobium parvulum , Streptococcus mutans and Prevotella melaninogenica were significantly more abundant in smokers. Our findings indicated an early onset of smoking-related changes already in the oral microbiome of adolescents.

Peri-implantitis is a severe biofilm-associated infection affecting millions worldwide. This cross-sectional study aimed to identify taxonomic and functional biomarkers that reliably indicate peri-implantitis by utilizing paired data from full length 16S rRNA gene amplicon sequencing (full-16S) and metatranscriptomics (RNAseq) in 48 biofilm samples from 32 patients. Both full-16S and RNAseq analyses revealed significant differences between healthy and peri-implantitis samples, with a shift toward anaerobic Gram-negative bacteria in peri-implantitis. Metatranscriptomics identified enzymatic activities and metabolic pathways associated with peri-implantitis and uncovered complex peri-implant biofilm ecology related to amino acid metabolism. Integrating taxonomic and functional data enhanced predictive accuracy (AUC = 0.85) and revealed diagnostic biomarkers including health-associated Streptococcus and Rothia species and peri-implantitis-associated enzymes (urocanate hydratase, tripeptide aminopeptidase, NADH:ubiquinone reductase, phosphoenolpyruvate carboxykinase and polyribonucleotide nucleotidyltransferase). Thus, biofilm profiling at taxonomic and functional levels provides highly predictive disease biomarkers, laying the foundation for novel diagnostic and personalized treatment approaches for peri-implant disease.

Medical devices have revolutionized patient care; however, their abiotic surfaces remain highly susceptible to bacterial biofilm formation, enabling immune evasion and antibiotic resistance. Although antibacterial coatings can mitigate bacterial colonization, many rely on antimicrobial agents that may drive resistance and often lack the capacity to actively modulate host immunity or promote osteogenesis. Here, we introduce innovative Commensal Hybrid Materials (CHMs), multifunctional implant interfaces generated by coating titanium with commensal microflora via a heat-anchoring inactivation process to create a safe, stable surface layer. Surface analyses (SEM/EDS, FTIR, Raman, XPS) confirmed a thick, near-hydrophobic coating with a polar biomolecular overlayer bearing protein (amide), lipid (C–H), and phosphate/phosphoryl signatures. CHMs were non-haemolytic, biocompatible with human cells, enhanced macrophage antimicrobial activity by increasing reactive oxygen species production while maintaining balanced phagocytosis, and reduced biofilm formation by the periodontal pathogen Porphyromonas gingivalis. CHMs induced balanced macrophage polarization and osteoimmunomodulation, increasing expressions of IL-1β, TNF-α (M1), IL-10 (M2), and the osteoinductive mediator oncostatin M (OSM), while significantly upregulating RUNX2 in co-cultured periodontal ligament stem cells with an early, self-limiting cytokine profile. In a clinically relevant human immunocompetent three-dimensional implant-tissue-oral-bacterial-biofilm (INTERbACT) model integrating fibroblasts, epithelial cells, macrophages, and multispecies biofilms, CHMs preserved epithelial integrity under dysbiotic challenge and significantly reduced biofilm volume while tuning macrophages toward both antimicrobial (M1) and reparative (M2) states. CHMs also reduced pro-inflammatory cytokine expression under both sterile and biofilm-exposed conditions. Collectively, CHMs uniquely combine biofilm resistance, immune-mediated clearance, and osteogenic stimulation, supporting translation to dental and orthopaedic implants. [Display omitted] •Novel biohybrid implants (CHMs) coated with commensal microflora exhibit potent biofilm-repellent activity.•CHMs mediate osteoimmunomodulatory effects through macrophage–stem cell crosstalk.•In the human immunocompetent 3D INTERbACT model, CHMs exhibit strong anti-biofilm activity against complex multispecies biofilms.•CHMs demonstrate biocompatibility along with immunomodulatory and anti-inflammatory activities in 3D tissue models.