The interaction between microscrew implants and the oral microbiota has emerged as a research focus in orthodontics in recent years. The application of microscrew implant anchorage may disrupt the ecological balance of normal oral microorganisms. Coupled with the susceptibility to plaque accumulation around the microscrew implant, this can induce peri-implant inflammation and ultimately lead to orthodontic treatment failure. A lack of in-depth understanding of microscrew implant anchorage from the perspective of oral microecology may increase the risk of anchorage loss. This article reviews the intrinsic relationship between microscrew implant anchorage failure and oral microecology, aiming to elucidate the potential mechanisms underlying their interaction and to provide a theoretical reference for reducing the incidence of peri-implantitis and associated failure risks.

Shiting Bi, Qiaoyu Xu, Yidan Ma, Jianguo Liu, Xiaoyan Guan, Suhan Jin. Research Progress on the Correlation between Oral Microecological Imbalance and Microscrew Implant Anchorage Failure. International Journal of Frontiers in Medicine (2026), Vol. 8, Issue 2: 35-44. https://doi.org/10.25236/IJFM.2026.080204.

[1] Zhang G N, Liu Y, Li W Y, Fan T T, Wang J, Zhao Z J. Correlation between social psychology and personality characteristics and treatment options for adult patients with skeletal malocclusion[J]. West China Journal of Stomatology, 2020, 38(3): 312-317. (in Chinese)

[2] Mizrahi, E., The use of Miniscrews in Orthodontics: A Review of Selected Clinical Applications. Primary Dental Journal, 2016. 5(4): p. 20-27.

[3] Rosier, B.T., P.D. Marsh, and A. Mira, Resilience of the Oral Microbiota in Health: Mechanisms That Prevent Dysbiosis. J Dent Res, 2018. 97(4): p. 371-380.

[4] Balenseifen, J.W. and J.V. Madonia, Study of dental plaque in orthodontic patients. J Dent Res, 1970. 49(2): p. 320-4.

[5] Feldmann, I. and L. Bondemark, Orthodontic anchorage: a systematic review. Angle Orthod, 2006. 76(3): p. 493-501.

[6] Li L Q. Clinical application of micro-implant anchorage in orthodontics[J]. Chinese Community Doctors (Medical Professional), 2011, 13(30): 45. (in Chinese)

[7] Ma Y S, Han B, Liu Y, Bai Y F, Zhang X H. In vitro study of multifunctional orthodontic adhesive for preventing enamel demineralization[J]. Beijing Journal of Stomatology, 2019, 27(6): 306-312. (in Chinese)

[8] Park, H.S., S.H. Jeong, and O.W. Kwon, Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofacial Orthop, 2006. 130(1): p. 18-25.

[9] Jin A P, Hu X C, Huang Y Y. Application of micro-implant anchorage in orthodontics[J]. Chinese Journal of Aesthetic Medicine, 2011, 20(6): 968-969. (in Chinese)

[10] Zhou S S, Sun Y, Wu G P, Song D, Li Y. Alkali-producing metabolism of plaque biofilm and dental caries[J]. International Journal of Stomatology, 2016, 43(5): 573-577. (in Chinese)

[11] Ghannoum, M.A., et al., Characterization of the oral fungal microbiome (mycobiome) in healthy individuals. PLoS Pathog, 2010. 6(1): p. e1000713.

[12] Pride, D.T., et al., Evidence of a robust resident bacteriophage population revealed through analysis of the human salivary virome. Isme j, 2012. 6(5): p. 915-26.

[13] Matarazzo, F., et al., Diversity and quantitative analysis of Archaea in aggressive periodontitis and periodontally healthy subjects. J Clin Periodontol, 2011. 38(7): p. 621-7.

[14] Liu, X., et al., Analysis of subgingival microbiome of periodontal disease and rheumatoid arthritis in Chinese: A case-control study. Saudi J Biol Sci, 2020. 27(7): p. 1835-1842.

[15] Jiang, Q., et al., The Oral Microbiome in the Elderly With Dental Caries and Health. Front Cell Infect Microbiol, 2018. 8: p. 442.

[16] Chen, W.P., et al., Composition Analysis and Feature Selection of the Oral Microbiota Associated with Periodontal Disease. Biomed Res Int, 2018. 2018: p. 3130607.

[17] Long, J., et al., Association of oral microbiome with type 2 diabetes risk. J Periodontal Res, 2017. 52(3): p. 636-643.

[18] Farrugia, C., G.P. Stafford, and C. Murdoch, Porphyromonas gingivalis Outer Membrane Vesicles Increase Vascular Permeability. J Dent Res, 2020. 99(13): p. 1494-1501.

[19] Han, Y.W. and X. Wang, Mobile microbiome: oral bacteria in extra-oral infections and inflammation. J Dent Res, 2013. 92(6): p. 485-91.

[20] Scarano, A., et al., Bacterial adhesion on commercially pure titanium and anatase-coated titanium healing screws: an in vivo human study. J Periodontol, 2010. 81(10): p. 1466-71.

[21] Nascimento, C.D., et al., Bacterial adhesion on the titanium and zirconia abutment surfaces. Clin Oral Implants Res, 2014. 25(3): p. 337-343.

[22] van Brakel, R., et al., Early bacterial colonization and soft tissue health around zirconia and titanium abutments: an in vivo study in man. Clin Oral Implants Res, 2011. 22(6): p. 571-7.

[23] Bollen, C.M., et al., The influence of abutment surface roughness on plaque accumulation and peri-implant mucositis. Clin Oral Implants Res, 1996. 7(3): p. 201-11.

[24] Almaguer-Flores, A., et al., Bacterial Adhesion on Polyelectrolyte Modified Microstructured Titanium Surfaces. MRS Online Proceedings Library, 2011. 1277(1): p. 1.

[25] Amarante, E.S., et al., Early dental plaque formation on toothbrushed titanium implant surfaces. Am J Dent, 2008. 21(5): p. 318-22.

[26] Fathy Abo-Elmahasen, M.M., et al., Do silver/hydroxyapatite and zinc oxide nano-coatings improve inflammation around titanium orthodontic mini-screws? In vitro study. Int Orthod, 2023. 21(1): p. 100711.

[27] Aboelmahasen, M.M.F., et al., Histomorphometric and CBCT comparison of osseointegration around orthodontic titanium miniscrews coated with different nanoparticles: An in-vivo animal study. Int Orthod, 2024. 22(1): p. 100823.

[28] Al-Hilaly, A.A. and A.F. Alhuwaizi, Assessment of coated orthodontic miniscrews with chlorhexidine hexametaphosphate antimicrobial nanoparticles: A randomized clinical trial. J World Fed Orthod, 2025. 14(2): p. 67-75.

[29] Nyvad, B. and M. Kilian, Microbiology of the early colonization of human enamel and root surfaces in vivo. Scand J Dent Res, 1987. 95(5): p. 369-80.

[30] de Freitas, A.O., et al., Microbial colonization in orthodontic mini-implants. Braz Dent J, 2012. 23(4): p. 422-7.

[31] Bachtiar, B.M., et al., Four-Week Evaluation of the Interaction Pattern Among Saccharibacteria, Nitrate-Reducing Bacteria, and Periodontopathogens in Orthodontic Miniscrew Implants. Dent J (Basel), 2025. 13(9).

[32] Mishra, G., et al., A pattern of microbiological colonization of orthodontic miniscrew implants. Am J Orthod Dentofacial Orthop, 2023. 164(4): p. 554-566.

[33] Apel, S., et al., Microflora associated with successful and failed orthodontic mini-implants. Clin Oral Implants Res, 2009. 20(11): p. 1186-90.

[34] Ferreira, N.O., et al., Bacterial biofilm on successful and failed orthodontic mini-implants--a scanning electron microscopy study. Microsc Res Tech, 2015. 78(12): p. 1112-6.

[35] Ghanbari, H.O., et al., Evaluation of periodontal condition in intruded molars using miniscrews. Journal of Dental Materials and Techniques, 2015. 4(4): p. 145-152.

[36] Song, Y.Y., J.Y. Cha, and C.J. Hwang, Mechanical characteristics of various orthodontic mini-screws in relation to artificial cortical bone thickness. Angle Orthod, 2007. 77(6): p. 979-85.

[37] Qian, Y., H.J. Zhou, and J.H. Wu, Clinical effects of micro-implant and traditional anchorage in orthodontic treatments. Shanghai Journal of Stomatology, 2017. 26(3): p. 339-342.

[38] Favero, R., et al., Maintaining Hygiene in Orthodontic Miniscrews: Patient Management and Protocols-A Literature Review. Dent J (Basel), 2024. 12(7).

[39] Cui, Z., P. Wang, and W. Gao, Microbial dysbiosis in periodontitis and peri-implantitis: pathogenesis, immune responses, and therapeutic. Front Cell Infect Microbiol, 2025. 15: p. 1517154.

[40] Thurnheer, T., N. Bostanci, and G.N. Belibasakis, Microbial dynamics during conversion from supragingival to subgingival biofilms in an in vitro model. Mol Oral Microbiol, 2016. 31(2): p. 125-35.

[41] Kinniment, S.L., et al., Development of a steady-state oral microbial biofilm community using the constant-depth film fermenter. Microbiology (Reading), 1996. 142 ( Pt 3): p. 631-638.

[42] Shank, S.B., et al., Bone damage associated with orthodontic placement of miniscrew implants in an animal model. Am J Orthod Dentofacial Orthop, 2012. 141(4): p. 412-8.

[43] Bartold, P.M., et al., Influence of surface roughness and shape on microdamage of the osseous surface adjacent to titanium dental implants. Clin Oral Implants Res, 2011. 22(6): p. 613-8.

[44] Di Spirito, F., et al., Microbiota of Peri-Implant Healthy Tissues, Peri-Implant Mucositis, and Peri-Implantitis: A Comprehensive Review. Microorganisms, 2024. 12(6).

[45] Jia, P., et al., Microbiome of diseased and healthy implants-a comprehensive microbial data analysis. Front Cell Infect Microbiol, 2024. 14: p. 1445751.

[46] Wen Y, Wang Y L. Research progress on plaque biofilm and peri-implantitis[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2024, 32(9): 730-736. (in Chinese)

[47] Luo, R., et al., An examination of the LPS-TLR4 immune response through the analysis of molecular structures and protein-protein interactions. Cell Commun Signal, 2025. 23(1): p. 142.

[48] Korea, C.G., J.M. Ghigo, and C. Beloin, The sweet connection: Solving the riddle of multiple sugar-binding fimbrial adhesins in Escherichia coli: Multiple E. coli fimbriae form a versatile arsenal of sugar-binding lectins potentially involved in surface-colonisation and tissue tropism. Bioessays, 2011. 33(4): p. 300-11.

[49] Uitto, V.J., et al., A protease of Bacteroides gingivalis degrades cell surface and matrix glycoproteins of cultured gingival fibroblasts and induces secretion of collagenase and plasminogen activator. Infect Immun, 1989. 57(1): p. 213-8.

[50] Chang, M.C., et al., Effect of Butyrate on Collagen Expression, Cell Viability, Cell Cycle Progression and Related Proteins Expression of MG-63 Osteoblastic Cells. PLoS One, 2016. 11(11): p. e0165438.

[51] Chen H J, Wang D, Shen S. Mechanism of immune-inflammatory microenvironment in peri-implantitis[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(8): 2054-2062. (in Chinese)

[52] Li, Y., et al., Immune dysregulation and macrophage polarization in peri-implantitis. Front Bioeng Biotechnol, 2024. 12: p. 1291880.

[53] Morandini, A.C., et al., Editorial: Microbial dysbiosis and immune dysregulation in periodontitis and peri-implantitis. Front Cell Infect Microbiol, 2025. 15: p. 1637248.

[54] Zou, W. and Z. Bar-Shavit, Dual modulation of osteoclast differentiation by lipopolysaccharide. J Bone Miner Res, 2002. 17(7): p. 1211-8.

[55] McGowan, N.W., et al., Cytokine-activated endothelium recruits osteoclast precursors. Endocrinology, 2001. 142(4): p. 1678-81.

[56] Sheikhi, M., A. Gustafsson, and C. Jarstrand, Cytokine, elastase and oxygen radical release by Fusobacterium nucleatum-activated leukocytes: a possible pathogenic factor in periodontitis. J Clin Periodontol, 2000. 27(10): p. 758-62.

[57] He, W., H. Zhu, and C. Liu, Profiles of inflammation factors and inflammatory pathways around the peri-miniscrew implant. Histol Histopathol, 2021. 36(9): p. 899-906.

[58] Hall, J.W. and Y. Ji, Sensing and Adapting to Anaerobic Conditions by Staphylococcus aureus. Adv Appl Microbiol, 2013. 84: p. 1-25.

[59] Higashi, D.L., et al., An inflammatory paradox: strategies inflammophilic oral pathobionts employ to exploit innate immunity via neutrophil manipulation. Front Oral Health, 2024. 5: p. 1413842.

[60] Mehrnia, N. and T.E. Van Dyke, Microbial dysbiosis and immune dysregulation in periodontitis and peri-implantitis. Front Cell Infect Microbiol, 2025. 15: p. 1678163.

[61] Gibbs, S., et al., Biology of soft tissue repair: gingival epithelium in wound healing and attachment to the tooth and abutment surface. Eur Cell Mater, 2019. 38: p. 63-78.

[62] Jin, C., et al., Substrate roughness induces the development of defective E-cadherin junctions in human gingival keratinocytes. J Periodontal Implant Sci, 2017. 47(2): p. 116-131.

[63] Surrency, S., et al., 3D Peri-Implant Epi-Mucosa-on-a-Chip Reveals Alterations in Epithelial Barrier Function Mediated by Host-Bacteria-Biomaterial Interactions. ACS Biomater Sci Eng, 2025. 11(12): p. 7134-7148.

[64] Udagawa, N., et al., Osteoclast differentiation by RANKL and OPG signaling pathways. J Bone Miner Metab, 2021. 39(1): p. 19-26.

[65] Kearns, A.E., S. Khosla, and P.J. Kostenuik, Receptor activator of nuclear factor kappaB ligand and osteoprotegerin regulation of bone remodeling in health and disease. Endocr Rev, 2008. 29(2): p. 155-92.

[66] Kong, Y.Y., et al., Activated T cells regulate bone loss and joint destruction in adjuvant arthritis through osteoprotegerin ligand. Nature, 1999. 402(6759): p. 304-9.

[67] Wada, T., et al., RANKL-RANK signaling in osteoclastogenesis and bone disease. Trends Mol Med, 2006. 12(1): p. 17-25.

[68] Schluessel, S., et al., Dental and Orthopaedic Implant Loosening: Overlap in Gene Expression Regulation. Front Immunol, 2022. 13: p. 820843.

[69] Hajishengallis, G. and T. Chavakis, Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nat Rev Immunol, 2021. 21(7): p. 426-440.

[70] Chen, G., et al., Peri-implant diseases triggered by oral microdysbiosis: pathogenesis and precision intervention strategies. Front Microbiol, 2025. 16: p. 1639095.

[71] Talib, E.Q., et al., Microbial boundaries in peri-implantitis: a review of pathogen-related advances. Folia Med (Plovdiv), 2024. 66(6): p. 763-769.

[72] Vílchez, B., et al., Longitudinal Changes in the Peri-Implant Microbiome Following Implant Placement: A 3-Year Follow-Up Study. Clin Oral Implants Res, 2026.

[73] Ferreira, S.D., et al., Prevalence and risk variables for peri-implant disease in Brazilian subjects. J Clin Periodontol, 2006. 33(12): p. 929-35.

[74] Darby, I., Risk factors for periodontitis & peri-implantitis. Periodontol 2000, 2022. 90(1): p. 9-12.

[75] Gnanasekar, S., et al., Antibacterial MXenes: An emerging non-antibiotic paradigm for surface engineering of orthopedic and dental implants. Bioact Mater, 2025. 51: p. 150-176.

[76] Jadhav, L., V. Madiwal, and J.M. Rajwade, The dental implant surface: a review of the past, present and future. J Mater Sci Mater Med, 2026. 37(1): p. 21.

[77] Ren J Y, Zhou W J. Research progress on decreased susceptibility of oral bacteria to chlorhexidine and related mechanisms[J]. Journal of Oral Science Research, 2024, 40(8): 670-675. (in Chinese)

[78] Bartsch, S., et al., Chlorhexidine digluconate mouthwash alters the oral microbial composition and affects the prevalence of antimicrobial resistance genes. Front Microbiol, 2024. 15: p. 1429692.

[79] Joshi, A.A., et al., The Submucosal Microbiome Correlates with Peri-implantitis Severity. J Dent Res, 2026. 105(3): p. 313-322.