Soft tissue wound healing around teeth and dental implants

Abstract

Aim To provide an overview on the biology and soft tissue wound healing around teeth and dental implants. Material and Methods This narrative review focuses on cell biology and histology of soft tissue wounds around natural teeth and dental implants. Results and conclusions The available data indicate that: Oral wounds follow a similar pattern. The tissue specificities of the gingival, alveolar and palatal mucosa appear to be innately and not necessarily functionally determined. The granulation tissue originating from the periodontal ligament or from connective tissue originally covered by keratinized epithelium has the potential to induce keratinization. However, it also appears that deep palatal connective tissue may not have the same potential to induce keratinization as the palatal connective tissue originating from an immediately subepithelial area. Epithelial healing following non‐surgical and surgical periodontal therapy appears to be completed after a period of 7–14 days. Structural integrity of a maturing wound between a denuded root surface and a soft tissue flap is achieved at approximately 14‐days post‐surgery. The formation of the biological width and maturation of the barrier function around transmucosal implants requires 6–8 weeks of healing. The established peri‐implant soft connective tissue resembles a scar tissue in composition, fibre orientation, and vasculature. The peri‐implant junctional epithelium may reach a greater final length under certain conditions such as implants placed into fresh extraction sockets versus conventional implant procedures in healed sites.

Effect of Platelet Rich Fibrin (PRF) on Peri-implant Soft Tissue and Crestal Bone in One-Stage Implant Placement: A Randomized Controlled Trial

“…The reduction in tissue changes observed within three month indicated achievement of tissue stability around implant. The results of this study support the efficacy of this procedure in maintaining the gingival architecture in accordance with similar studies [14,17,18]. In this study intra-oral periapical radiographs used for the assessment of bone level were obtained by using paralleling technique to minimize distortion and standardized by using occlusal putty jig.…”

Effect of platform switching on crestal bone levels around implants in the posterior mandible: 3 years results from a multicentre randomized clinical trial

“…2011c, Sculean et al. 2014). In fact, animal studies have shown that implant sites with narrower mucosal thickness consistently reveal marginal bone resorption to adjust for the acceptable biological width around implants (Berglundh & Lindhe 1996), which could be the clinical situation associated to PM when compared to PS restorations.…”

The response of human osteoblasts, epithelial cells, fibroblasts, macrophages and oral bacteria to nanostructured titanium surfaces: a systematic study

“…41 In this study, to figure out the roles of surface morphology during the soft tissue integration, both HGECs and HGFs from human gingival tissue were cultured on different titanium surfaces for systemic analysis. The data showed that after 24 hours of incubation, HGECs on the Nano surface spread readily and exhibited upregulated gene expression of integrin α6β4, the major component of the hemidesmosome, and laminin α3β3γ2 (laminin-5), the major component of the basement membrane, compared to the Smooth and Micro surfaces.…”