Significance of Keratinized Mucosa and Implant Health

Lin, Guo‐Hao; Wang, Hom‐Lay

doi:10.1007/978-3-030-39185-0_8

Cited by 2 publications

(4 citation statements)

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“…Moreover, disintegration and recession of soft tissue around dental implants occurs faster and is more severe compared to that around natural teeth. 3 Junctional epithelium and healthy connective tissue around teeth are the first line of defense against microbial invasion, and adequate biologic seal is the cornerstone of dental implant success. 4 Supracrestal collagen fibers are vertically oriented relative to the tooth surface and are attached to the cementum covering the root surface.…”

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confidence: 99%

“…However, these fibers are oriented parallel around dental implants. 3,5,6 The biologic width around dental implants is 3-4 mm, which is composed of junctional epithelium and the connective tissue fibers, which are positioned parallel to the implant surface. 4 In an observational study, Loe and Lang suggested 2 mm of keratinized tissue width, including 1 mm of attached gingiva around dental implants.…”

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confidence: 99%

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Correlation of keratinized tissue width and periodontal indices around implant-supported fixed partial dentures

Farhoudi

Parsay²

2018

J Adv Periodontol Implant Dent

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Background. The effect of keratinized tissue width on the peri-implant health has not been well elucidated. The results of previous studies on this topic are controversial and the role of keratinized tissue width in the long-term success of dental implants has not been confirmed. This cross-sectional study aimed to assess the correlation of keratinized tissue width with periodontal indices around implant-supported fixed partial dentures (FPDs). Methods. This cross-sectional study evaluated 73 implants. Patients underwent periodontal examinations, including measurement of plaque index (PI), gingival index (GI), clinical probing depth (PD), bleeding on probing (BOP), marginal gingival recession, keratinized mucosa width and radiographic marginal bone level. Data were analyzed using SPSS. Results. The mean GI, PI and marginal gingival recession around implants with <2 mm width of keratinized gingiva were greater than the corresponding values around implants with keratinized tissue width of ≥2 mm. However, this difference was not statistically significant (P>0.05). No significant differences were noted in PD and radiographic marginal bone level between the two implant groups with keratinized tissue width <2 mm and ≥2 mm. Thus, no correlation was found between the keratinized tissue width and the measured indices. Conclusion. Although this study did not show a significant correlation between the keratinized tissue width and peri-implant tissue health and consequently the implant success rate, long-term interventional studies are required to make a final judgment in this respect.

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confidence: 99%

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confidence: 99%

Correlation of keratinized tissue width and periodontal indices around implant-supported fixed partial dentures

Farhoudi

Parsay²

2018

J Adv Periodontol Implant Dent

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“…After removing natural teeth, both soft tissues and the surrounding bone levels/contours are altered, and the dimension of the keratinised tissue is reduced. The importance of having a tight keratinised mucosa around dental implants has been noted , Lin et al, 2013, Giovannoli et al, 2019 but the significance of a firmly attached keratinised mucosa around dental implants is controversial. Implants that do not have keratinised mucosa show an increased mucosal recession and more attachment loss (Lin et al, 2013).…”

Section: Peri-implant Tissuesmentioning

confidence: 99%

“…The importance of having a tight keratinised mucosa around dental implants has been noted , Lin et al, 2013, Giovannoli et al, 2019 but the significance of a firmly attached keratinised mucosa around dental implants is controversial. Implants that do not have keratinised mucosa show an increased mucosal recession and more attachment loss (Lin et al, 2013). Lack of keratinised tissue has also been associated with problems with toothbrushing, affecting daily oral hygiene (Souza et al, 2016).…”

Section: Peri-implant Tissuesmentioning

confidence: 99%

Peri-implantitis: risk factors and outcome of reconstructive therapy

Ahmad¹

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This thesis is focused on (I) the outcome of reconstructive treatment of peri-implant defects and (II) risk factors for the development of peri-implantitis. Background An increasing number of individuals have dental implant-supported reconstructions. The long-time survival rate of dental implants is good, but complications do occur. Accumulation of bacteria on oral implants and the development of a pathogenic biofilm at the mucosal margin will result in inflammatory responses diagnosed as peri-implant mucositis(PiM). Furthermore, PiM may progress to peri-implantitis (Pi) involving the implant-supporting bone and potentially result in a severe inflammatory process resulting in alveolar bone destruction and consequently implantloss. Currently, Pi is a common clinical complication following implant therapy.The prevalence of peri-implantitis has been reported to be around 20 %. Susceptibility to infections and a history of periodontitis are considered as important risk indicators for peri-implantitis. It seems logical that a past history of periodontitis is linked to an increased risk of peri-implantitis. It is possible that other patient-associated factors such as a smoking habit, and presence of general diseases may also be linked to a higher risk for developing peri-implantitis.Treatment of peri-implantitis is difficult. Non-surgical treatment modalities may not be sufficient to resolve the inflammatory process to obtain healthy conditions.Surgical treatment of peri-implantitis has commonly been employed in clinical practice to obtain access to the implant surface thereby increasing the possibility to effectively decontaminate the implant surfaces.The effectiveness and long-term outcomes of reconstructive surgical treatments of peri-implantitis has been debated. The scientific evidence suggests that regular supportive care is an essential component in order to maintain and secure long-term results following treatment of peri-implantitis. Aims 1. To assess the short-term efficacy of reconstructive surgical treatmentof peri-implantitis (Study I). 2. To analyse risk factors related to the occurrence of peri-implantitis(Study II). 3. To assess the importance of defect configuration on the healing response after reconstructive surgical therapy of peri-implantitis (Study III). 4. To assess the long-term efficacy of reconstructive surgical treatmentof peri-implantitis (Study IV). MethodsFour studies were designed to fulfil the aims: - A single-blinded prospective randomised controlled longitudinal human clinical trial evaluating the clinical and radiographic results of reconstructive surgical treatment of peri-implantitis defects usingeither AB or BDX. - A retrospective analysis of individuals with either peri-implantitis, or presenting with either peri-implant health, or peri-implant mucositis assessing the likelihood that peri-implantitis was associated with a history of systemic disease, a history of periodontitis, and smoking. - A prospective study evaluating if the alveolar bone defect configuration at dental implants diagnosed with peri-implantitisis related to clinical parameters at the time of surgical intervention and if the short- and long-term outcome of surgical intervention of peri-implantitis is dependent on defect configuration at the time of treatment. - A prospective 5-year follow-up of patients treated either with AB or BDX. Results - The success for both surgical reconstructive procedures was limited. Nevertheless, bovine xenograft provided evidence of more radiographic bone fill than AB. Improvements in PD, BOP, and SUP were observed for both treatment modalities -In relation to a diagnosis of peri-implantitis, a high likelihood of comorbidity was expressed in the presence of a history of periodontitis and a medical history of cardiovascular disease - The buccal-lingual width of the alveolar bone crest was explanatory to defect configuration - 4-wall defects and deeper defects demonstrated more radiographic evidence of defect fill - Reconstructive surgical treatment of peri-implant defects may result in successful clinical outcomes, that can be maintained over at least five years - The use of BDX is more predictable than use of harvested bone from the patient (AB) Conclusions The study results suggest that a bovine xenograft provides better radiographic evidence of defect fill than the use of autogenous bone harvested from cortical autologous bone grafts.Treatment with bone grafts to obtain radiographic evidence of defect fill is more predictable at 3- and 4-wall defects than at peri-implantitis bone defects with fewer bone walls.In relation to a diagnosis of peri-implantitis, a high likelihood of comorbidity was found for a history of periodontitis and a history of cardiovascular disease.

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Significance of Keratinized Mucosa and Implant Health

Cited by 2 publications

References 102 publications

Correlation of keratinized tissue width and periodontal indices around implant-supported fixed partial dentures

Correlation of keratinized tissue width and periodontal indices around implant-supported fixed partial dentures

Peri-implantitis: risk factors and outcome of reconstructive therapy

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