Evolution in the peri-implant oral microbiome and their relationship to long-term marginal bone loss: A randomized clinical study Galindo Moreno, Pablo Antonio Gutierrez Garrido, Lourdes Duarte, Juan Robles Vera, Iñaki Martín Morales, Natividad O'Valle Ravassa, Francisco Javier Olaechea, Allinson Carrillo Gálvez, Ana Belén Padial Molina, Miguel Marginal bone loss Early loading Dental implants Microbiome Peri-Implantitis Objectives: To analyze the clinical, radiographic and microbiological changes around implants with a multiphosphonate-treated surface, prosthetically loaded with two different protocols, after five years of functional loading. Material and methods: A randomized clinical trial was designed to initiate prosthetic loading over single dental implants after 8 (control) or 4 weeks (test). Several variables were analyzed, including patient’s level variables, intrasulcular biofilm and marginal bone level at several time points, from 1 to 60 months after loading. Results: 23 patients attended the 5 years follow-up visit. No clinical variable changed over time, except mucosal thickness from dental impressions to prosthesis delivery. No significant radiographic differences were observed neither over time nor between groups. Microbiologically, there was a change in the microbiome from the constitution of the biological width to the final follow-up. Seven species changed significantly, with a significant increase in Porphyromonas gingivalis and Tannerella forsythia from 12 to 60 months and a decrease in the other species. However, changes in relative abundance of species along the time, whether increasing or decreasing, did not show a correlation with marginal bone loss. Conclusion: Implants with a multiphosphonate-treated surface showed no differences in clinical and radiographic variables after 5 years of function, regardless of the prosthetic loading protocol used. From a microbiological point of view, although there was an evolution of the microbiome in the peri-implant sulcus towards Socransky's red circle pathogenic bacteria, no microorganism showed significant correlation with the radiographic changes produced in the peri-implant bone over time. 2025-07-11T07:42:06Z 2025-07-11T07:42:06Z 2025-03-10 journal article Galindo-Moreno P, Gutierrez-Garrido L, Duarte J, Robles-Vera I, Martin-Morales N, O'Valle F, Olaechea A, Carrillo-Galvez AB, Padial-Molina M. Evolution in the Peri-Implant Oral Microbiome and Their Relationship to Long-Term Marginal Bone Loss: A Randomized Clinical Study. Clin Oral Implants Res. 2025 Jul;36(7):802-820. doi: 10.1111/clr.14426. Epub 2025 Mar 10. PMID: 40062725; PMCID: PMC12230925. https://hdl.handle.net/10481/105198 10.1111/clr.14426 eng http://creativecommons.org/licenses/by-nc-nd/4.0/ open access Attribution-NonCommercial-NoDerivatives 4.0 Internacional Wiley