Influence of the keratinized mucosa on the stability of peri‐implant tissues and brushing discomfort: A 4‐year follow‐up study

Abstract

Objective The purpose of the present prospective follow‐up study was to evaluate the long‐term influence of the peri‐implant keratinized mucosa (KM) on marginal bone level (MBL), peri‐implant tissues health, and brushing discomfort. Material and Methods Eighty patients were initially recruited during their maintenance visit from January to October 2013 and allocated in two groups according to KM width around implants: Wide Group (KM ≥ 2 mm) and Narrow Group (KM < 2 mm). In the four‐year follow‐up examination (T4), marginal bone level (MBL), modified plaque index (mPI), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BoP), and brushing discomfort (BD) were reassessed and compared to the initial assessments (T0). Mann–Whitney, Wilcoxon signed‐rank test, and a multilevel model were used for the statistical analysis. Results Fifty‐four patients with 202 implants returned at T4. Mean mPI (0.91 ± 0.60), BoP (0.67 ± 0.21), and BD (12.28 ± 17.59) were higher in the Narrow Group than in the Wide Group (0.54 ± 0.48, 0.56 ± 0.26, and 4.25 ± 8.39, respectively). Marginal bone loss was higher in the Narrow Group (0.26 ± 0.71) than in the Wide Group (0.06 ± 0.48). Multilevel analysis suggested that KM width and time in function had a statistically significant effect on MBL. Conclusions The findings of the present study indicate that KM width had an effect on MBL, plaque accumulation, tissue inflammation, and brushing discomfort over the studied period. Thus, the presence of a KM ≥ 2 mm around implants appears to have a protective effect on peri‐implant tissues.

Free gingival grafts for implants exhibiting a lack of keratinized mucosa: Extended follow‐up of a randomized controlled trial

“…Few subjective symptoms were observed in this study while other studies stated that higher brushing discomfort was reported from patients with implants displaying <2 mm KM (Perussolo, Souza, Matarazzo, Oliveira, & Araújo, 2018; Roccuzzo, Grasso, & Dalmasso, 2016). Seven subjects in the no‐surgery group did not want the study intervention (FGG) because they did not experience any discomfort during the course of the study or even before the study.…”

Effect of different implant placement depths on crestal bone levels and soft tissue behavior: A 5‐year randomized clinical trial

“…Adequate (usually ≥ 2mm) soft tissue thickness and keratinized mucosa width have been reported to lead to healthier peri‐implant soft and hard tissues (Grischke et al, ), as well as to promote less bone loss, improved oral hygiene (Perussolo et al, ), and better mucosal esthetics (Bonino et al, ). A subanalysis performed in the present study revealed that VMT <2 mm did not affect the bone remodeling around equi‐ and subcrestal implants since no statistically significant difference was found.…”

Influence of keratinized mucosa on the surgical therapeutical outcomes of peri‐implantitis

“…Peri‐implantitis is characterized by a non‐linear and accelerating pattern of peri‐implant marginal bone loss (Derks et al, ), where a lack of KM has been suggested to contribute towards the onset of peri‐implantitis (Gobbato et al, ; Lin et al, ). In fact, a very recent prospective follow‐up study demonstrated that KM width and time in function had a statistically significant effect on MBL (Perussolo, Souza, Matarazzo, Oliveira, & Araujo, ). This was supportive of previous findings (Zigdon & Machtei, ).…”