Recession of the soft tissue margin at oral implants. A 2‐year longitudinal prospective study.

Abstract

The aim of this study was to longitudinally evaluate alterations in the position of the periimplant soft tissue margin, occurring during a 2-year period after insertion of fixed prostheses. 41 patients, subjected to treatment with partial or full-arch implant supported fixed prostheses based on a total of 163 standard Brånemark oral implants, were included in the study. A baseline examination was performed at time of insertion of the prosthetic construction and involved assessments of plaque, mucositis, probing depth, bleeding on probing marginal soft tissue level, width of masticatory mucosa and marginal soft tissue mobility. All patients were re-examined after 6 months, and after 1 and 2 years, respectively. A regression analysis was performed to evaluate if alterations, occurring in the position of the periimplant soft tissue margin during the 2 years, could be predicted by various variables recorded at time of the installation of the fixed prosthesis. The descriptive analysis showed a slight decrease in mean probing depth (0.2 mm) and width of masticatory mucosa (0.3 mm) during the follow-up period. Apical displacement of the soft tissue margin mainly took place during the first 6 months of observation. Lingual sites in the mandible showed the most pronounced soft tissue recession, decrease of probing depth, and decrease of width of masticatory mucosa. The statistical analysis revealed that lack of masticatory mucosa and mobility of the periimplant soft tissue at time of bridge installation were poor predictors of soft tissue recession occurring during the 2 years of follow-up, but indicated in greater amount of recession in women than men, in the mandible than in the maxilla, at lingual than at facial sites and with increased initial probing depth. It was suggested that the recession of the periimplant soft tissue margin mainly may be the result of a remodelling of the soft tissue in order to establish "appropriate biological dimensions" of the periimplant soft tissue barrier, i.e., the required dimension of epithelial-connective tissue attachment in relation to the faciolingual thickness of the supracrestal soft tissue.

Marginal bone and soft tissue behavior following platform switching abutment connection/disconnection– a dog model study

“…At the end of the study (6-12 weeks), the barrier epithelium varied between 1.7 and 2.1 mm. These findings corroborated previous clinical results from a longitudinal study (Bengazi et al 1996). Authors evaluated the alterations in the position of the peri-implant soft tissue margin, during a 2-year period follow-up.…”

“…Facial soft tissue recession often occurs shortly after abutment connection/crown placement (Bengazi et al 1996, Small & Tarnow 2000, De Rouck et al 2008, but subsequently remains relatively stable during various observation periods (Adell et al 1986, Apse et al 1991, Jemt et al 1994, Bengazi et al 1996, Andersson et al 1998, Scheller et al 1998, Grunder 2000, Priest 2003, Cardaropoli et al 2006, Jemt et al 2006, Rompen et al 2007, De Rouck et al 2008. A thick mucosa (≥1 mm) at the mid-buccal aspect of implants was associated with less mucosal recession compared with a thin mucosa (<1 mm) (zigdon & Machtei 2008).…”

“…Prospective follow-up studies by Bengazi et al 1996 andSmall et al 2000 reported mean 0.4 mm of buccal recession after 6 months of prosthesis insertion, possible due to early bone deterioration. This is with an agreement with retrospective studies of Grunder et al 2000, which showed about 0.6 mm of soft tissue recession and Ekfeldt et al 2003 reporting 0.8 mm soft tissue apical migration in the first year after crown placement.…”

“…Hence, complete papilla fill may only be established when the distance between the contact point and the bone crest is a maximum of 3 -4 mm. Further, loss in height of the proximal bone crest may negatively affect the patient's esthetic appreciation of the implant therapy, because concomitant with the alterations of the bone crest soft tissue recession may take place (Bengazi et al 1996). Table 3 a) Inter-tooth units.…”

Treatment of Labial Soft Tissue Recession Around Dental Implants in the Esthetic Zone Using Guided Bone Regeneration With Mineralized Allograft: A Retrospective Clinical Case Series

“…5, 7 However , this has been disputed. [2][3][8][9] One study 6 reported a correlation between the presence of keratinized tissue, plaque levels and the incidence of mucositis, and theorized that sites with minimal keratinized tissue might be prone to a lower incidence of periodontal pocket formation. 3,10 In the anterior maxilla, however, the contribution of thick, keratinized gingiva to implant esthetics has not been disputed.…”