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

Abstract

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.

The significance of surgically modifying soft tissue phenotype around fixed dental prostheses: An American Academy of Periodontology best evidence review

“…The main features and conclusions of the included studies were summarized in Table 4. The features and outcomes of the studies that included a secondary outcome analysis of tissue phenotype are displayed in supplementary Table S1 (around implants) 3,[37][38][39][40]43,[57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75] and supplementary Table S2 (around teeth) 48,76 in online Journal of Periodontology where the influence of phenotype on clinical outcomes is identified.…”

“…If the tissue presents healthy, BOP should not be a common finding on examination . However, soft tissue grafting procedures have been widely performed as one of the treatment modalities to manage peri‐implantitis . With the modification of prosthetic designs, soft tissue grafting procedures have also been introduced to manage mal‐positioned implant fixtures .…”

“…91 However, soft tissue grafting procedures have been widely performed as one of the treatment modalities to manage peri-implantitis. 72 With the modification of prosthetic designs, soft tissue grafting procedures have also been introduced to manage mal-positioned implant fixtures. 92 In addition, evidence supports that PhMT-s can increase KTW and further improve patient comfort and compliance during oral hygiene.…”

Effects of Nano-Hydroxyapatite/Polyetheretherketone-Coated, Sandblasted, Large-Grit, and Acid-Etched Implants on Inflammatory Cytokines and Osseointegration in a Peri-Implantitis Model in Beagle Dogs

“…With the exception of higher long-term implant survival, maintaining functionally loaded implants with adequate health and aesthetics has become a prerequisite for implant restoration success [ 3 ]. As the number of patients who have implant-supported dentures increases, dentists are increasingly dealing with peri-implant soft and hard tissues diseases [ 4 ]. As there are large differences between dental implants and natural teeth, their maintenance is critical for the success and longevity of osseointegrated implants [ 3 ].…”