The peri‐implant phenotype and implant esthetic complications. Contemporary overview

Abstract

Objective To provide a contemporary and comprehensive overview of the hard and soft tissue biological structures surrounding an osseointegrated dental implant (peri‐implant referred to as the peri‐implant phenotype), in the context of peri‐implant esthetic complications. Overview The individual components of the peri‐implant phenotype (keratinized mucosa width, mucosal thickness, supracrestal tissue height, and the peri‐implant buccal bone) have been linked to different aspects of implant esthetics, as well as health‐related aspects. At the time of implant therapy, respecting the biology of the peri‐implant hard and soft tissues, and anticipating their remodeling patterns can alleviate future esthetic complications. Conclusions While the current literature may not allow for a point‐by‐point evidence based‐recommendation for the required amount of each peri‐implant structure, bearing in mind the proposed values for the components of the peri‐implant phenotype, at the time of and prior to implant therapy can lead to more predictable treatment outcomes, and the avoidance of esthetic complications. Clinical Significance Knowledge of hard and soft tissue components surrounding and osseointegrated dental implant, and their underlying biological remodeling process is crucial for carrying out a successful therapy and alleviating possible future esthetic challenges.

Clinical evaluation of xenogeneic collagen matrix versus free gingival grafts for keratinized mucosa augmentation around dental implants: A randomized controlled clinical trial

“…As an indispensable component of the peri-implant phenotype, mucosal thickness plays an essential role in the maintenance of peri-implant health and aesthetic complications of implant therapy (Avila-Ortiz Wang et al, 2021). A thicker mucosa has been proved to be associated with lower incidence of mucosal recession and less marginal bone loss (Kan et al, 2011;Thoma et al, 2018;Tavelli et al, 2021).…”

“…“Peri‐implant phenotype” is a new term coined to describe the morphological and dimensional features of a dental implant, encompassing peri‐implant KMW, mucosal thickness, supracrestal tissue height, and peri‐implant bone thickness (Avila‐Ortiz et al, 2020). As an indispensable component of the peri‐implant phenotype, mucosal thickness plays an essential role in the maintenance of peri‐implant health and aesthetic complications of implant therapy (Avila‐Ortiz et al, 2020; Wang et al, 2021). A thicker mucosa has been proved to be associated with lower incidence of mucosal recession and less marginal bone loss (Kan et al, 2011; Thoma et al, 2018; Tavelli et al, 2021).…”

Methods to assess tooth gingival thickness and diagnose gingival phenotypes: A systematic review

“…Patients with a less gingival thickness and keratinized tissue width were more susceptible to mucosal recession after orthodontic treatment 9 . Regarding the peri‐implant aesthetic complications, assessment of the peri‐implant phenotype is critical for a successful therapy and promises fewer aesthetic challenges 10,11 . Therefore, an accurate assessment and description of periodontal soft tissue dimensions is critical for clinical decision‐making and aesthetic outcome prediction.…”

Ultrasonographic Tissue Perfusion in Peri-implant Health and Disease

“…Implant therapy has become the standard treatment for replacement of missing teeth. Nevertheless, with its popularity, there has been a rise in aesthetic and biological complications and the emergence of peri-implant diseases (Derks et al 2016a;Renvert et al 2018;Wang et al 2021). The 2017 World Workshop on peri-implant diseases and conditions (Berglundh et al 2018) recognized peri-implant mucositis and peri-implantitis as inflammatory conditions affecting the implant soft tissues, with the latter involving the peri-implant hard tissues and loss of the implant's supporting bone (Schwarz et al 2018).…”