Peri-implantitis is a severe infectious and inflammatory complication of dental implantation capable of undermining treatment outcomes. The aim of the work is to conduct a systematic analysis and integration of scientific data to determine the role of microbial dysbiosis in the pathogenesis of the disease, with an emphasis on taxonomic and functional shifts in the peri-implant microbiome. The methodological basis includes a systematic review and analytical synthesis of peer-reviewed studies selected from the Scopus and Web of Science databases. The body of results indicates that what matters is not so much the presence of individual periodontopathogens as a pronounced dysbiotic restructuring of the community, manifesting as increased microbial diversity and the dominance of Gram-negative obligate anaerobes. The principal pathogenetic link is the functional reorganization of the microbiocenosis: a shift from homeostasis-oriented carbohydrate metabolism to destructive amino acid catabolism. This metabolic drift is accompanied by the accumulation of proinflammatory metabolites, dysregulation of the host immune response, and subsequent activation of bone resorption. The conclusions support the concept of functional dysbiosis as the central mechanism in the development of peri-implantitis. The analysis underscores the need to shift the therapeutic focus from elimination-based interventions to strategies for restoring microbial homeostasis and opens prospects for the development of diagnostic and therapeutic approaches based on microbiome biomarkers. The information presented in the article will be of interest to dental clinicians, implantologists, periodontologists, and researchers in the fields of oral microbiology and immunology.
Rubenova Aidana (Wed,) studied this question.