Treatment of peri-implant soft tissue defects: a narrative review

Abstract

Soft tissue defects around dental implants, such as papilla or volume loss, peri-implant recession and alterations of the ridge color and/or texture, lead to esthetic and functional complaints. Treatments of these defects in implants are more demanding than in teeth because peri-implant tissue exhibits different anatomical and histological characteristics. This narrative review discusses the proposed treatments for soft tissue defects around implants in the current literature. Several clinical and pre-clinical studies addressed methods to augment the quantity of the peri-implant keratinized mucosa. Autogenous grafts performed better than soft tissue substitutes in the treatment of soft tissue defects, but there is no clinical consensus on the more appropriate donor area for connective tissue grafts. Treatment for facial volume loss, alterations on the mucosa color or texture and shallow peri-implant recessions are more predictable than deep recessions and sites that present loss of papilla. Correction of peri-implant soft tissue defects may be challenging, especially in areas that exhibit larger defects and interproximal loss. Therefore, the regeneration of soft and hard tissues during implant treatment is important to prevent the occurrence of these alterations.

Correlation between Buccal Bone Thickness at Implant Placement in Healed Sites and Buccal Soft Tissue Maturation Pattern: A Prospective Three-Year Study

“…Thus, current research has turned its attention to the parameters that determine the aesthetic success of rehabilitation [10]. Certainly, the height of the soft tissue around a dental implant is key in determining a natural aesthetic result [28], as no rehabilitation showing recessions can be considered an aesthetic achievement [28]. Accordingly, the amounts of hard and soft tissue around a dental implant are clearly very important [2].…”

Efficacy of free gingival graft in the augmentation of keratinized tissue around implants: A prospective clinical study

“…This outcome further supports the results drawn in a study that stated that the formation of the interdental papilla is completely unpredictable with mobile nonkeratinized tissue and a firm zone of keratinized tissue is needed for a predictable interdental papilla formation. [ 15 ] Further, a study conducted by Zigdon and Machtei showed a greater mucosal recession around dental implants surrounded with inadequate keratinized tissue. [ 3 ]…”

“…[ 11 ] Health of peri-implant tissues was also evaluated at 3 and 6 months after the second stage of gingival augmentation procedure using plaque index (Silness and Loe, 1964), gingival index (Loe and Silness, 1963), papillary index (Jemt, 1997), and marginal recession (Miller, 1985) levels. [ 12 13 14 15 ]…”

Preservation of Peri-Implant Papilla: A Narrative Review

“…Multiple factors affect the treatment of papilla loss using filler materials, but clinical trials on humans have shown more promising results in the interdental rather than inter-implant papilla. 63…”