Association of Herpes Virus Type 1, Cytomegalo Virus and Epstein-Barr Virus to the Pathogenesis of Peri-Implantitis: A Cross-Sectional Study.

Background/Objectives: This study explores the potential relationship between herpesvirus infections and the severity and progression of peri-implantitis. A secondary goal is to investigate whether a virus-bacteria interaction may contribute to differences in bone loss patterns between periodontitis and peri-implantitis. Methods: Biological samples, including blood, saliva, and peri-implant crevicular fluid, were collected for viral detection. Blood samples were processed at Queen Mary Laboratory in Bucharest, Romania, while saliva and peri-implant crevicular fluid samples were analyzed at the laboratory of ADD Laboral in Malden, the Netherlands. Sterile paper points were used to collect peri-implant crevicular fluid from the deepest peri-implant sites in 43 patients. A nearby tooth was sampled when present, with edentulous patients being the exception. Several clinical parameters were also considered, including implant and dentition status, smoking, gender, implant location, duration of functional loading, periodontal pocket depth (PPD), bleeding on probing (BoP), suppuration (SUP), and periodontal history. Results: Epstein-Barr virus (EBV) was detected in 30.2% of cases, Herpes virus (HSV) in 7.0%, and Cytomegalo virus (CMV) in 0%. EBV showed a moderate inverse correlation with probing depth (r = -0.48) in non-smokers with periodontal disease. Viral detection was highest on lingual and mesial surfaces. Peri-implantitis cases exhibited significantly deeper PPD, higher BoP (96.15%), and suppuration (96.15%) compared to healthy implants or teeth. Conclusions: An association was observed between the presence of Herpes viruses and increased peri-implantitis severity, suggesting a potential contributory role of viral pathogens in disease progression.