Histologic Evaluation of Soft Tissues around Dental Implant Abutments: A Narrative Review

Abstract

The basis for dental implant success comes not only with the titanium implant osseointegration but also depends on other factors such as the development of a soft tissue barrier, which protects the peri-implant bone from the oral environment. The characteristics of surfaces in contact with peri-implant soft tissues may affect the capacity of peri-implant mucosal cells to create a tight seal around the implant, thus influencing long-term implant success. Many histological studies on animals have been conducted on different materials to better understand their influence on peri-implant soft tissues, with the limitation that results from animal studies cannot be fully translated in humans. The aim of this review paper was to analyze the literature focusing on histological clinical studies in humans which have examined different materials or different surface treatments and their effects on peri-implant soft tissues. The research was conducted according to the following PICO question: “Do different implant/abutment materials affect peri-implant soft tissues adhesion and health?”. Nine articles were analyzed in this review. The results of this review show the influence of different abutment materials on the peri-implant soft tissues, and the need of further research regarding the effect that abutment materials, surface treatments, and surface properties have on soft tissues.

Influences of standardized clinical probing on peri‐implant soft tissue seal in a situation of peri‐implant mucositis: A histomorphometric study in dogs

“…13 The collagen fibers mainly originate from the periosteum of the alveolar bone crest, extending to the mucosal margin (MM), and predominantly to the implant surface, parallel to the implant surface, in contrast to the perpendicular orientation at teeth. 9,14 Possessing these unique characteristics, peri-implant tissues may be less resistant to mechanical forces than periodontal tissues. 8 It was certified by higher bleeding on probing (BOP) percentage of implants than natural teeth under probing force over 0.15 N in a split-mouth clinical study.…”

“…Peri‐implant mucosa is commonly recognized as scar tissue with reduced nutrition supply and fewer gingival fibroblasts owing to the lack of a periodontal ligament 13 . The collagen fibers mainly originate from the periosteum of the alveolar bone crest, extending to the mucosal margin (MM), and predominantly to the implant surface, parallel to the implant surface, in contrast to the perpendicular orientation at teeth 9,14 . Possessing these unique characteristics, peri‐implant tissues may be less resistant to mechanical forces than periodontal tissues 8 .…”

Nanoparticles of Cerium-Doped Zeolitic Imidazolate Framework-8 Promote Soft Tissue Integration by Reprogramming the Metabolic Pathways of Macrophages

“…The epithelial components are similar, while the biological structure of the connective tissue surrounding the abutment differs from that of healthy periodontal connective tissues due to the persistent presence of the implant. The connective tissue around the abutment includes more collagen fibers but less blood vessels and fibroblasts, similar to scar tissue . When soft tissue is being remodeled, fibroblasts perform a number of different tasks, including fiber creation, cell attachment to surfaces, and constriction to lock down soft tissue .…”

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.…”