Originally published in Dentaltown, December 2025.
The December 2025 issue of Dentaltown features a detailed implant case from Dr. Edward R. Kusek — a diplomate of the American Board of Oral Implantology and immediate past president of the American Academy of Implant Dentistry — in which salivary diagnostics helped shape the treatment plan from the outset.
The case follows a 45-year-old patient who lost tooth #14 to periodontal disease and needed a lateral sinus augmentation before an implant could be placed. As part of the workup, Dr. Kusek used OraPath bacterial testing to measure the patient’s levels of aggressive red-complex organisms (P. gingivalis, T. forsythia, T. denticola, A. actinomycetemcomitans, F. nucleatum). The panel returned high values of Porphyromonas gingivalis, Tannerella forsythia, and Fusobacterium nucleatum. After a course of oral probiotics, a repeat panel showed those pathogens had dropped substantially — confirming the microbial picture had shifted before surgery.
It’s a practical illustration of how quantifying the oral microbiome, rather than inferring it, gives clinicians a defensible, longitudinal basis for managing the systemic factors that can compromise implant success. Dr. Kusek frames salivary testing as the first step in a workflow that also drew on probiotics, high-intensity laser therapy, and platelet-rich fibrin to reach a predictable outcome.