The gut-bone axis: gut microbiota dysbiosis and dental implant failures – Is there a link? - A systematic review

<ns3:p>Introduction The gut microbiota plays a pivotal role in systemic health, particularly in bone metabolism and periodontal integrity, through the gut–bone axis. Emerging evidence suggests that gut microbiota dysbiosis may indirectly contribute to dental implant failure by disrupting bone homeostasis and aggravating periodontal disease. Despite growing recognition of this relationship, comprehensive understanding of the underlying mechanisms and therapeutic strategies remains limited. This systematic review explores the impact of gut microbiota dysbiosis on implant-related tissues, its contribution to implant failure, and potential non-invasive interventions to improve outcomes. Methods A systematic search of PubMed, Scopus, Embase, and related databases was performed following PRISMA guidelines. Studies addressing the gut microbiota–bone health connection, gut microbiota–periodontium interactions, and their collective influence on implant success were included. Screening was based on predefined criteria, with data extraction focusing on mechanisms through which dysbiosis affects osseointegration and peri-implant health, as well as therapeutic approaches including probiotics, prebiotics, and dietary interventions. Results The review revealed a strong association between gut dysbiosis and altered bone metabolism, impairing osseointegration and raising the risk of implant failure. Gut dysbiosis also exacerbated periodontal inflammation, predisposing to peri-implant mucositis and peri-implantitis. Non-invasive strategies such as probiotics, prebiotics, and targeted dietary modifications showed promise in restoring microbial balance, attenuating systemic inflammation, and supporting peri-implant tissue health. However, wide heterogeneity in study design and methodology restricted the strength and comparability of available evidence. Conclusion Gut microbiota dysbiosis is an emerging and underrecognized risk factor for implant failure. Modulating dysbiosis through non-invasive interventions may enhance osseointegration and peri-implant tissue integrity. Nevertheless, most current evidence arises from preclinical or small-scale human studies, highlighting the urgent need for robust, large-scale clinical trials.</ns3:p>