Etiology and Treatment of Peri-Implant Soft Tissue Dehiscences: A Narrative Review

Abstract

Implant soft tissue dehiscences compromise not only the aesthetics of the supported restorations but implant survival in the long run. The aim of this narrative review was to briefly present the causative factors of buccal peri-implant soft tissue dehiscences (PSTDs), how these are classified, and the current therapeutic approaches. Implant malposition and the thin peri-implant phenotype are the two major determinants for the occurrence of PSTDs, but other risk factors have also been identified. The most common surgical procedure for treating PSTDs is the split-thickness coronally advanced flap combined with either a connective tissue graft or acellular dermal matrix materials. However, depending on the class and subtype of the dehiscence, the combination of surgical techniques with modifications in the restoration may further ameliorate the final result. In general, within a five-year follow-up period, most techniques lead to a satisfactory aesthetic result, although full coverage of the implant/abutment surface is not always achievable, especially in more extended lesions.

Application of computer-aided design and 3D-printed template for accurate bone augmentation in the aesthetic region of anterior teeth

“…The design of the osteotomy line, which could remove the weak bone wall and de ne the shape of the bone defect area, was determined. The objectives for virtual osteotomy are as follows: (1) retaining the height of the interalveolar septa of the adjacent teeth, while maintaining a distance of ≥ 1.5 mm from the adjacent periodontal membrane; (2) trimming alveolar ridge crests with at or inclined planes in the recipient site, removing uneven bone crests, and retaining a bucco-lingual width ≥ 5 mm in the alveolar bone; (3) ensuring a rectangular or trapezoidal osteotomy area, with no undercut, which does not hinder the placement of the bone graft.…”

“…Implant restoration in the aesthetic zone of the anterior teeth should be performed considering the aesthetic effect of the proportion of the pink (gingiva) and white (teeth) regions, in addition to ensuring that the biting and cutting functions are maintained [1,2]. This has always been challenging in clinical implant restorations, especially in cases of severe bone loss; further, the treatment options for such cases are limited [3,4].…”

“…According to the determined location of the osteotomy line of the alveolar bone and iliac bone, the virtual osteotomy was performed by data segmentation (2). The maxillary model after osteotomy and the 3D model of the iliac bone were established.…”

Association between Peri-Implant Soft Tissue Health and Different Prosthetic Emergence Angles in Esthetic Areas: Digital Evaluation after 3 Years’ Function

“…The role of an adequate band of keratinized mucosa around dental implants has been widely investigated in the literature. Even then, higher values of mucosa recession and loss of attachment were correlated with inadequate width of keratinized mucosa [ 3 , 4 , 5 ]. Keratinized oral epithelium continues in the sulcular epithelium and then in the junctional epithelium; this is a non-keratinized epithelium that, due to its unique structural and functional adaptation, plays a critical role in maintaining periodontal health by forming the front line of defense against periodontal bacterial infection.…”

Application of computer-aided design and 3D-printed template for accurate bone augmentation in the aesthetic region of anterior teeth

“…Implant restoration in the aesthetic zone of the anterior teeth should be performed considering the aesthetic effect of the proportion of the pink (gingiva) and white (teeth) regions, in addition to ensuring that the biting and cutting functions are maintained [ 1 , 2 ]. This has always been challenging in clinical implant restorations, especially in cases of severe bone loss; further, the treatment options for such cases are limited [ 3 , 4 ].…”