Influence of presence or absence of keratinized mucosa on the alveolar bony crest level as it relates to different buccal marginal bone thicknesses. An experimental study in dogs

Bengazi, Franco; Botticelli, Daniele; Favero, Vittorio; Perini, Alessandro Paoletti; Vélez, Joaquín Urbizo; Lang, Niklaus P.

doi:10.1111/clr.12233

Cited by 50 publications

(62 citation statements)

References 30 publications

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“…Our clinical findings support the view that KM around dental implants in erratic maintenance compliers seems necessary for maintaining peri‐implant health, and are consistent with previously reported pre‐clinical and clinical observations . Moreover, recent data have evidenced the influence of the width of KM upon the peri‐implant clinical parameters in relation to the onset and resolution of experimental peri‐mucositis in humans .…”

Section: Discussionsupporting

confidence: 91%

Significance of keratinized mucosa/gingiva on peri‐implant and adjacent periodontal conditions in erratic maintenance compliers

Monje

Blasi

2018

Journal of Periodontology

122

179

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Background Given the fact that most patients are not regular compliers in supportive peri‐implant maintenance programs, it is of interest to examine the significance of the peri‐implant soft tissue characteristics in relationship to the onset of peri‐implant diseases. Methods Based on an a priori statistical power calculation, a cross‐sectional study was conducted on erratic peri‐implant maintenance compliers (<2 times/year) to examine the significance of keratinized mucosa (KM) and gingival tissue (KT) on peri‐implant and adjacent periodontal conditions in implants restored ≥3 years. Seven clinical parameters were recorded around implants and the adjacent buccal sites. Radiographic assessment was performed using periapical X‐rays. In addition, a visual analog scale (VAS) was used to evaluate the impact of KM upon brushing comfort. The case definition used for peri‐implant diseases was in accordance with the 2017 World Workshop on the classification of periodontal and peri‐implant diseases and conditions. Results Overall, 37 patients with 45 edentulous gaps restored with 66 implants and 90 adjacent teeth were analyzed. On comparing a KM band of <2 mm versus ≥2 mm, with the exception of suppuration (P = 0.6), all the clinical and radiographic parameters were significantly increased when the KM band was <2 mm (P < 0.001). A significant correlation was observed between KM and KT (r = 0.55), though a lack of KM did not condition a lack of KT. In the presence of peri‐implantitis, only bleeding on probing at the adjacent dentate sites was identified to be increased. Conclusions The presence of <2 mm of KM around dental implants in erratic maintenance compliers seems to be associated with peri‐implant diseases. The lack of KM constitutes a site‐specific phenomenon independent of the keratinized tissue present in the adjacent dentition (NCT03501537).

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Section: Discussionsupporting

confidence: 91%

Significance of keratinized mucosa/gingiva on peri‐implant and adjacent periodontal conditions in erratic maintenance compliers

Monje

Blasi

2018

Journal of Periodontology

122

179

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“…39,40 A recent animal model demonstrated that a thin band of keratinized mucosa (,1.7 mm) rather than biotype or bone thickness was correlated with recession over time after implant placement. 41 Moreover, increasing the band of keratinized mucosa with free gingival grafts was found to reduce soft tissue recession and resorption of crestal buccal bone for the short term. 42 More research in the arena is required to understand the etiology of implant recessions and their correction.…”

Section: Hard Tissuementioning

confidence: 99%

Implant Associated Soft Tissue Defects in the Anterior Maxilla

Anderson

Inglehart²,

El-Kholy³

et al. 2014

Implant Dentistry

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“…In spite of the fact that the quality and quantity of the peri-implant soft tissue has a very important effect on the marginal peri-implant bone loss [10, 27–30], there are no approaches in the literature for the soft-tissue grafting as a therapeutic method which can be used alone after initial treatment. The present study showed that in most cases and even by undesired peri-implant defect morphologies, stabilization of the soft tissue and reduction of the peri-implant inflammatory process could be achieved.…”

Section: Discussionmentioning

confidence: 99%

“…So that an adequate keratinized mucosa at the implant site leads to a reduced plaque accumulation, a reduced inflammatory mucosal infiltration, and a pro-inflammatory mediator release [9]. This was confirmed in an animal study of Benghazi et al, they showed in their study that in case of missed keratinized mucosa, bone resorption and prevalence of soft-tissue recession could be reduced through soft-tissue grafting [10]. …”

Section: Introductionmentioning

confidence: 91%

Soft-tissue grafting for peri-implantitis—a treatment option in case of unsuitable skeletal basic morphology of the alveolar bone and lack of keratinized mucosa: a retrospective clinical cohort study

et al. 2015

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BackgroundThis retrospective study evaluated soft-tissue grafting as a surgical treatment option for peri-implantitis in case of unsuitable basic skeletal morphology of the alveolar bone and lack of keratinized mucosa.MethodsTwenty-eight patients (21 females, 7 males, at a mean age 59.4 years) were included with a total of 54 implants. All implants showed peri-implantitis and attached keratinized buccal mucosa of ≤2 mm. A surgical procedure of soft-tissue grafting (STG) was made by inserting an inlay and inlay-onlay transplant. Clinical investigations were made prior to the STG (baseline) and after 9–180 months (Ø 43 months) including the following parameters: soft-tissue biotype, skeletal basic morphology of the alveolar bone, width of the peri-implant keratinized mucosa (KM), mobility of the KM, pocket probing depth (PPD), and bleeding on probing (BOP).ResultsNearly all patients showed a thin soft-tissue biotype. The analysis of the skeletal basic morphology of the alveolar bone revealed a narrow apical base in 18 patients, middle base in 7 patients, and broad base in 3 patients. Width of the KM increased significantly (p < 0.01) from 0.4 ± 0,5 mm to 4.3 ± 1.5 mm after STG and PPD was significantly (p < 0,01) reduced from 6.3 ± 2,3 mm to 4.1 ± 1.9 mm. A significant reduction (p < 0.01) in BOP was recorded. All patients reported a clinical improvement of the inflammatory symptoms at follow-up.ConclusionsThe results of this study showed that the STG can be applied successfully as a surgical treatment of peri-implantitis. It remains unclear whether soft-tissue biotype or the skeletal basic morphology of the alveolar bone affects the outcome of this surgical treatment.

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Influence of presence or absence of keratinized mucosa on the alveolar bony crest level as it relates to different buccal marginal bone thicknesses. An experimental study in dogs

Abstract: A higher alveolar buccal bony crest resorption and a more apical soft tissue marginal position should be expected, when implants are surrounded with thin alveolar mucosa at the time of installation, independently of the thickness of the buccal bony crest.

Cited by 50 publications

References 30 publications

Significance of keratinized mucosa/gingiva on peri‐implant and adjacent periodontal conditions in erratic maintenance compliers

Significance of keratinized mucosa/gingiva on peri‐implant and adjacent periodontal conditions in erratic maintenance compliers

Implant Associated Soft Tissue Defects in the Anterior Maxilla

Soft-tissue grafting for peri-implantitis—a treatment option in case of unsuitable skeletal basic morphology of the alveolar bone and lack of keratinized mucosa: a retrospective clinical cohort study

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