The Effect of Three Surgical Therapies to Increase Keratinized Mucosa Surrounding Dental Implants with Peri-Implantitis: A Pilot Study

Abstract

Background and Objectives: The purpose of this pilot study was to evaluate the clinical outcomes of three different methods for increasing the keratinized mucosa (KM) surrounding dental implants with peri-implantitis. Materials and methods: Twenty implant sites with peri-implantitis were divided into: (1) porcine collagen matrix (CM) group: seven implant sites; (2) apically positioned flap (APF) group: eight implant sites; and (3) free gingival graft (FGG) group: five implant sites. The KM width and clinical parameters (probing pocket depth (PPD) and bleeding on probing (BOP)) were measured at time points: before surgery (T0) and 30 (T1), 60 (T2), 90 (T3), and 180 (T4) days after surgery. Results: Regarding KM width, all the groups had significant differences for increasing horizontal and vertical KM width. The CM and FGG groups had greater KM than the APF group. There was a decrease in PPD in all three groups. APF and FGG showed significant differences in PPD at T1 and T2 compared to T0. Only the FGG group showed a significant difference in PPD at T3 and T4 compared with that at T0. BOP values were also reduced in all the groups at T1–T4 compared to T0. The APF and FGG groups showed a significant decrease in BOP. Conclusions: Three surgical therapies presented favorable results for increasing the KM surrounding implants. Compared with the FGG group, the CM showed similar results in increasing the KM around the dental implants with peri-implantitis.

Soft tissue features of peri‐implant diseases and related treatment

“…At 6 months, the mean KM width gain for APF, APF + CMX and APF + FGG was 1.62, 3.43, and 3.70 mm, respectively. The reduction of bleeding on probing was statistically significant only at implant sites allocated to FGG 164 …”

“…Nevertheless, better patient‐reported outcomes, in terms of lower post‐operative pain and perception of difficulty of the surgery, were observed in subjects that received CMX 163 . A three‐arm pilot study evaluated the efficacy of APF, APF + CMX and APF + FGG for the surgical resective treatment of peri‐implant disease 164 . All the interventions resulted in a reduction of the probing depth and in an increase of KW width.…”

Mini-Implants Retaining Removable Partial Dentures in Subjects without Posterior Teeth: A 5-Year Prospective Study Comparing the Maxilla and the Mandible

“…Younger patients probably develop higher occlusal forces because of chewing more vigorously, and there is a lack of proprioception of the implants [ 70 ]. However, the magnitude of occlusal forces was not measured, which is a limitation of this study, although different antagonistic jaw status (FPD, RPC, CD) did not elicit significant effects on peri-implant bone [ 71 ].…”

“…Limitations of the study, besides possible variations in the amount of chewing forces, may include the possible insufficient experience of the residents who inserted MDIs (although they were supervised by experienced specialists), the 2-dimensional assessment of peri-implant bone loss, small variations in dimensions of MDIs, and small variations of the thickness of keratinized mucosa around implants [ 71 ]. The existence of chronic stress and depression, which could influence peri-implant disease and bone loss through different mechanisms [ 72 ] was not evaluated.…”

First-in-Human Study to Investigate the Safety Assessment of Peri-Implant Soft Tissue Regeneration with Micronized-Gingival Connective Tissue: A Pilot Case Series Study

“…Therefore, reconstruction or augmentation of adequate peri-implant mucosa is indispensable for successful treatment in dental implants [ 4 , 5 , 6 ]. In clinical practice, the free gingival graft (FGG) and the connective tissue graft (CTG) are currently the gold standards for augmenting keratinized tissue [ 2 , 7 , 8 , 9 , 10 ]. The FGG and the CTG have been used to re-establish the keratinized tissue, correcting mucogingival deformities, and improving the esthetics at teeth and dental implant sites.…”