Compare and contrast dental implants and natural teeth, focusing on the following. A. Soft/hard tissue anatomy B. Blood supply C. Microbiology

What will be an ideal response?

A. There are many differences between implants and natural teeth. Implants do not develop caries, and there is no pulp; thus, implants do not develop root sensitivity. In natural teeth, the junctional epithelium provides a seal at the base of the sulcus. If this seal is disrupted, the junctional epithelium migrates apically onto the root surface. On the other hand, the implant-connective tissue interface is different from the natural tooth. In the implant, the junctional epithelium is referred to as a perimucosal seal. There is a lack of cementum with no connective tissue fibers inserting into the implant surface.
B. Implants have less blood supply near their neck with more of a scar tissue appearance. Lack of a periodontal ligament limits the blood supply to the area to only the periosteal vessels and bone marrow spaces.
C. Neither implants nor natural teeth are immune to plaque accumulation. The implant microflora are derived from the natural flora of the mouth. Some bacteria, such as Actinomyces viscosus and Streptococcus sanguis, adhere less to implants than to natural teeth. In health, the subgingival implant microflora is similar to that of natural healthy teeth. With the development of inflammation and increasing probing depths, there are elevated levels of spirochetes and gram-negative anaerobes and decreased levels of coccoid cells. Failing implants have a similar microflora to that of periodontal disease.