Is the presence of keratinized mucosa associated with periimplant tissue health? A clinical cross-sectional analysis

Abstract

BackgroundLong-term data concerning the impact of missing keratinized mucosa (KM) on periimplant tissue health are rare. The importance of KM for implant success remains unclear.MethodsTwo hundred eleven patients with 967 dental implants were analyzed up to 15 years after implant placement. Implants were divided into two groups: no keratinized mucosa (NKM) and KM. Evaluated parameters were plaque index (mAPI), bleeding index (mSBI), bleeding on probing (BOP), probing depth (PD), width of KM, and radiographic vertical bone level.ResultsmAPI, mSBI, and BOP were significantly higher for the NKM group. Implants of both groups showed no significant difference in PD and vertical bone level. Of the implants in the posterior regions (n = 261), 40.3% (regions 37 to 34, 44 to 47, 27 to 24, 17 to 14) showed NKM, whereas 30.4% of the implants in the anterior regions (regions 13 to 23; regions 33 to 43) presented NKM (n = 97).ConclusionsResults indicate that the presence of KM has a positive effect on periimplant tissue health, but does not seem to have an influence on the periimplant bone level.

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

“…Clinical assessments demonstrated that implants with KM < 2 mm exhibited higher mPI and BoP mean values than those with KM ≥ 2 mm both at T0 and T4, in agreement with previous clinical studies (Adibrad et al, ; Bouri et al, ; Chung et al, ; Ladwein et al, ; Souza et al, ). Meta‐analyses from recent systematic reviews (Gobbato, Avila‐Ortiz, Sohrabi, Wang, & Karimbux, ; Lin, Chan, & Wang, ) reported significant differences in plaque control and inflammation, suggesting that KM < 2 mm was associated with more plaque accumulation and peri‐implant tissue inflammation.…”

“…In contrast, others studies in the literature reported no association between KM width and MBL or bone loss around dental implants (Adibrad et al, ; Chung et al, ; Crespi et al, ; Ladwein et al, ; Roccuzzo et al, ). In a study using a sample composed by 967 implants at least 10 years in function, Ladwein et al () evaluated the relationship between KM presence and peri‐implant tissue health, and observed no association between KM width and MBL. However, differently from other studies, the authors conducted MBL measurements on panoramic radiographs, which are less reliable than periapical radiographs.…”

“…According to the literature, there is a high prevalence (ranging from 23.8% to 74%) of implants surrounded by KM < 2 mm (Adell et al, ; Apse, Zarb, Schmitt, & Lewis, ; Crespi, Capparè, & Gherlone, ; Kim et al, ; Ladwein, Schmelzeisen, Nelson, Fluegge, & Fretwurst, ; Lekholm et al, ; Mericske‐Stern, Steinlin Schaffner, Marti, & Geering, ; Roccuzzo, Grasso, & Dalmasso, ). Nonetheless, the importance of KM in the maintenance of peri‐implant tissues health and the long‐term success of implant therapy has been a matter of controversy.…”

Labially impacted maxillary canines after the closed eruption technique and orthodontic traction: A split‐mouth comparison of periodontal recession

“…The AGW in the impaction group was <2 mm, which was reported as the minimal amount required to maintain periodontal health . A deficient AGW may predispose the patient to periodontal inflammation and a subsequent loss of periodontal support, although recent studies suggest that even smaller amounts of KGW and AGW would be sufficient to maintain periodontal health …”

A retrospective study of an alternative technique for implant repositioning in the maxillary esthetic region

“…Often in cases of bone atrophy, keratinized mucosa may not be present, and techniques to increase the amount of keratinized mucosa may be performed during implant installation or second‐stage surgery. The presence of keratinized mucosa has a positive effect on peri‐implant tissue health . In a systematic review, Bassetti et al found that patients with sites with a width of <2 mm of keratinized mucosa developed discomfort during brushing more easily and also exhibited dental plaque accumulation and peri‐implant soft tissue inflammation.…”