Effects of Peri-implant Mucosal Characteristics on Clinical Peri-implant Parameters: A Retrospective Study

Year 2023, Volume: 24 Issue: 2, 105 - 111, 30.06.2023

Esra Bozkurt , Mustafa Özay Uslu

Abstract

Objective: This study aimed to examine the effects of peri-implant keratinized mucosa (KM) width and thickness on peri-implant soft tissue health in functionally loaded implants and evaluate the factors affecting peri-implant health.
Materials and Methods: A total of 645 implants from 169 patients were evaluated in this study. The duration of the implant followup ranged from 12 months to 46 months. Clinical measurements such as plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), KM width, mucosal phenotype (MP), and buccal mucosal recession (MR) of peri-implant sites were performed. Peri-implant mucosa was classified as healthy, peri-implant mucositis, and peri-implantitis.
Results: It was determined that the thickness and width of the KM around the implant did not affect the peri-implant soft tissue health and PI, GI, and BOP scores. PD was found to be significantly lower in peri-implant regions with KM width <2 mm and thin MP. CAL was found to be significantly higher in peri-implant regions with KM width <2 mm and thin MP. Significantly less buccal MR was detected in peri-implant regions with KM width ≥2 mm and thick MP. The peri-implant regions treated with the overdenture were significantly less healthy.
Conclusions: It was determined that the CM width and thickness around the implant did not have a significant effect on soft tissue health in patients who could achieve plaque control. It is important to provide sufficient KM width and thickness in the peri-implant soft tissue, especially in esthetic areas.

Keywords

Keratinized mucosa width, mucosal phenotype, mucosal recession, peri-implantitis, peri-implant mucositis

References

• 1. Lang NP, Löe H. The relationship between the width of keratinized gingiva and gingival health. J Periodontol 1972; 43: 623-7.
• 2. Adibrad M, Shahabuei M, Sahabi M. Significance of the width of keratinized mucosa on the health status of the supporting tissue around implants supporting overdentures. J Oral Implantol 2009; 35: 232-7.
• 3. Costa FO, Takenaka-Martinez S, Cota LO, Ferreira SD, Silva GL, Costa JE. Peri-implant disease in subjects with and without preventive maintenance: a 5-year follow-up. J Clin Periodontol 2012; 39: 173-81.
• 4. Ueno D, Nagano T, Watanabe T, Shirakawa S, Yashima A, Gomi K. Effect of the Keratinized Mucosa Width on the Health Status of Periimplant and Contralateral Periodontal Tissues: A Crosssectional Study. Implant Dent 2016; 25: 796-801.
• 5. Schrott AR, Jimenez M, Hwang JW, Fiorellini J, Weber HP. Fiveyear evaluation of the influence of keratinized mucosa on periimplant soft-tissue health and stability around implants supporting full-arch mandibular fixed prostheses. Clin Oral Implants Res 2009; 20: 1170-7.
• 6. Zigdon H, Machtei EE. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clin Oral Implants Res 2008; 19: 387-92.
• 7. Kim BS, Kim YK, Yun PY, Yi YJ, Lee HJ, Kim SG, et al. Evaluation of peri-implant tissue response according to the presence of keratinized mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: e24-8.
• 8. Heckmann SM, Karl M, Wichmann MG, Winter W, Graef F, Taylor TD. Cement fixation and screw retention: parameters of passive fit. An in vitro study of three-unit implant-supported fixed partial dentures. Clin Oral Implants Res 2004; 15: 466-73.
• 9. Bengazi F, Wennström JL, Lekholm U. Recession of the soft tissue margin at oral implants. A 2-year longitudinal prospective study. Clin Oral Implants Res 1996; 7: 303-10.
• 10. De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosyn J. The gingival biotype revisited: transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J Clin Periodontol 2009; 36: 428-33.
• 11. Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Periodontol 2018; 89 Suppl 1: S1-8.
• 12. Boynueğri D, Nemli SK, Kasko YA. Significance of keratinized mucosa around dental implants: a prospective comparative study. Clin Oral Implants Res 2013; 24: 928-33.
• 13. Buyukozdemir Askin S, Berker E, Akincibay H, Uysal S, Erman B, Tezcan İ, et al. Necessity of keratinized tissues for dental implants: a clinical, immunological, and radiographic study. Clin Implant Dent Relat Res 2015; 17: 1-12.
• 14. Cardaropoli G, Lekholm U, Wennström JL. Tissue alterations at implant-supported single-tooth replacements: a 1-year prospective clinical study. Clin Oral Implants Res 2006; 17: 165-71.
• 15. Mericske-Stern R, Steinlin Schaffner T, Marti P, Geering AH. Periimplant mucosal aspects of ITI implants supporting overdentures. A five-year longitudinal study. Clin Oral Implants Res 1994; 5: 9-18.
• 16. Polizzi G, Gualini F, Friberg B. A two-center retrospective analysis of long-term clinical and radiologic data of TiUnite and turned implants placed in the same mouth. Int J Prosthodont 2013; 26: 350-8.
• 17. John G, Becker J, Schwarz F. Modified implant surface with slower and less initial biofilm formation. Clin Implant Dent Relat Res 2015; 17: 461-8.
• 18. Palmer RM, Palmer PJ, Smith BJ. A 5-year prospective study of Astra single tooth implants. Clin Oral Implants Res 2000; 11: 179-82.
• 19. Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev 2014: CD003815.
• 20. Wennström JL, Ekestubbe A, Gröndahl K, Karlsson S, Lindhe J. Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects. A 5-year prospective study. J Clin Periodontol 2004; 31: 713-24.
• 21. Gharpure AS, Latimer JM, Aljofi FE, Kahng JH, Daubert DM. Role of thin gingival phenotype and inadequate keratinized mucosa width (<2 mm) as risk indicators for peri-implantitis and peri-implant mucositis. J Periodontol 2021; 92: 1687-96.
• 22. Migliorati M, Amorfini L, Signori A, Biavati AS, Benedicenti S. Clinical and Aesthetic Outcome with Post-Extractive Implants with or without Soft Tissue Augmentation: A 2-Year Randomized Clinical Trial. Clin Implant Dent Relat Res 2015; 17: 983-95.
• 23. Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003; 90: 121-32.
• 24. van Steenberghe D, Quirynen M, Naert I, Maffei G, Jacobs R. Marginal bone loss around implants retaining hinging mandibular overdentures, at 4-, 8- and 12-years follow-up. J Clin Periodontol 2001; 28: 628-33.
• 25. Marrone A, Lasserre J, Bercy P, Brecx MC. Prevalence and risk factors for peri-implant disease in Belgian adults. Clin Oral Implants Res 2013; 24: 934-40.