Background: Peri-implant microbial colonisation is one of the most critical determinants of the success of
osseointegration of implants and long-term outcomes. This in vivo study seeks to determine and compare qualitative
and quantitative changes that occur in peri-implant microflora during immediate and delayed implant placement.
Materials and Methods: A total of 30 systemically healthy participants who needed single tooth extraction and
implant placement were enrolled and equally allocated into two groups. Group A (immediate placement of an
implant), and Group B – a delayed implant placement 12 weeks after surgery. Peri-implant sulcus was sampled at the
start (pre-placing), the first month, and three months after placement. For this, sterile paper points were utilized.
Cultivation and identification were done by culture-based methods together with colony-forming unit (CFU) counts
for Streptococcus mutans, Porphyromonas gingivalis, and Fusobacterium nucleatum. Clinical measures such as
plaque index and gingival index, and peri-implant probing depth were also documented.
Results: Group A exhibited a higher mean CFU count for P. gingivalis (2.8 × 10⁵CFU/mL) than Group B (1.2 ×
10⁵CFU/mL). The S. mutans colonization at three months was comparable for both groups. There was a statistically
significant (p<0.05) increase in anaerobic species in Group A. The clinical parameters did not exceed the limits in
both groups. However, slightly better gingival scores and reduced inflammation were demonstrated in Group B.
Conclusion: One of the possible consequences of the immediate implant placement might be a higher level of
colonization of pathogenic anaerobic bacteria during the preceding period of healing in comparison with delayed
implant placement. Postponed placement may promote more optimal processes of soft tissue healing and microbial
stabilization. Monitoring of per-implant microbial profiles is critical in the beginning stages of implant therapy.
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