A Multi-center Study: The Impact of Dental Implants on Candida Colonization in the Oral Cavity and Their Response to Antifungal Agents

Background : Dental implants are a cornerstone of modern restorative dentistry; however, fungal colonization, particularly by Candida species, remains a clinical concern. This multi-center study aimed to evaluate the prevalence of Candida colonization on dental implants compared to natural teeth and to assess the susceptibility of these isolates to common antifungal agents. Methods : A cross-sectional multi-center study was conducted involving five clinical settings in Sana'a, Yemen, including the Faculty of Dentistry at Sana'a University and four specialized private dental centers. A total of 66 participants (34 with dental implants and 32 with natural teeth as a control group) were enrolled. Oral swabs were collected from the buccal mucosa and tongue and cultured on Sabouraud dextrose agar. And Chromogenic Agar. Colony-forming units (CFU/ml) were quantified, Fungal identification and antifungal susceptibility testing was performed for Nystatin, Fluconazole, Clotrimazole, Ketoconazole, and Amphotericin B were performed using standardized laboratory protocols. Results : Candida colonization was detected in both groups, with a higher prevalence in implant patients (52.9%) compared to controls (31.2%). The mean CFU count was 115.6 ± 42.3 CFU/ml in implant patients and 109.6 ± 38.7 CFU/ml in controls (p = 0.42). Amphotericin B showed the highest sensitivity (70%), while Fluconazole showed the lowest (35%). Conclusion : This study highlights that dental implants are more prone to Candida colonization than natural teeth. The findings from these diverse clinical centersemphasize the need for strict oral hygiene protocols and targeted antifungal therapy to prevent peri-implant complications