Abstract
The definition of a “successful implant” has evolved over the years to include, beyond functional utility, high esthetic outcomes. Nowadays, a definition of a successful dental implant includes, among others, the patient’s and clinician’s esthetic satisfaction, which is achieved by a restoration that is in harmony with the surrounding teeth and tissues [1]. The final restoration should match the size, form, and color of the adjacent teeth and be framed by soft tissues consistent in color, shape, and texture [2] (Fig. 2.1).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Myshin HL, Wiens JP. Factors affecting soft tissue around dental implants: a review of the literature. J Prosthet Dent. 2005;94(5):440–4.
Palacci P, Nowzari H. Soft tissue enhancement around dental implants. Periodontology. 2008;47(1):113–32.
Fu J-H, Su C-Y, Wang H-L. Esthetic soft tissue management for teeth and implants. J Evid Based Dent Pract. 2012;12(3):129–42.
Wennström JL, Derks J. Is there a need for keratinized mucosa around implants to maintain health and tissue stability? Clin Oral Implants Res. 2012;23:136–46.
Brito C, Tenenbaum HC, Wong BK, Schmitt C, Nogueira-Filho G. Is keratinized mucosa indispensable to maintain peri-implant health? A systematic review of the literature. J Biomed Mater Res B Appl Biomater. 2014;102(3):643–50.
Greenstein G, Cavallaro J. The clinical significance of keratinized gingiva around dental implants. Compend Contin Educ Dent. 2011;32(8):24–31.
Thoma DS, Mühlemann S, Jung RE. Critical soft-tissue dimensions with dental implants and treatment concepts. Periodontology. 2014;66(1):106–18.
Zigdon H, Machtei EE. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clin Oral Implants Res. 2008;19(4):387–92.
Jung RE, Heitz-Mayfield L, Schwarz F, Meeting GotnOFC. Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus Report Part 3—Aesthetics of peri-implant soft tissues. Clin Oral Implants Res. 2018;29:14–7.
van Brakel R, Noordmans HJ, Frenken J, de Roode R, de Wit GC, Cune MS. The effect of zirconia and titanium implant abutments on light reflection of the supporting soft tissues. Clin Oral Implants Res. 2011;22(10):1172–8.
Sailer I, Zembic A, Jung RE, Siegenthaler D, Holderegger C, Hämmerle CHF. Randomized controlled clinical trial of customized zirconia and titanium implant abutments for canine and posterior single-tooth implant reconstructions: preliminary results at 1 year of function. Clin Oral Implants Res. 2009;20(3):219–25.
Zembic A, Sailer I, Jung RE, Hämmerle CHF. Randomized-controlled clinical trial of customized zirconia and titanium implant abutments for single-tooth implants in canine and posterior regions: 3-year results. Clin Oral Implants Res. 2009;20(8):802–8.
Jung RE, Sailer I, Hammerle C, Attin T, Schmidlin P. In vitro color changes of soft tissues caused by restorative materials. Int J Periodontics Restorative Dent. 2007;27(3):251.
Jung RE, Holderegger C, Sailer I, Khraisat A, Suter A, Hämmerle CH. The effect of all-ceramic and porcelain-fused-to-metal restorations on marginal peri-implant soft tissue color: a randomized controlled clinical trial. Int J Periodontics Restorative Dent. 2008;28(4):357–65.
Puisys A, Linkevicius T. The influence of mucosal tissue thickening on crestal bone stability around bone-level implants. A prospective controlled clinical trial. Clin Oral Implants Res. 2015;26(2):123–9.
Akcalı A, Trullenque-Eriksson A, Sun C, Petrie A, Nibali L, Donos N. What is the effect of soft tissue thickness on crestal bone loss around dental implants? A systematic review. Clin Oral Implants Res. 2017;28(9):1046–53.
Schneider D, Grunder U, Ender A, Hämmerle CH, Jung RE. Volume gain and stability of peri-implant tissue following bone and soft tissue augmentation: 1-year results from a prospective cohort study. Clin Oral Implants Res. 2011;22(1):28–37.
Olsson M, Lindhe J. Periodontal characteristics in individuals with varying form of the upper central incisors. J Clin Periodontol. 1991;18(1):78–82.
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(5):428–33.
Becker W, Ochsenbein C, Tibbetts L, Becker BE. Alveolar bone anatomic profiles as measured from dry skulls. J Clin Periodontol. 1997;24(10):727–31.
Kao RT, Fagan MC, Conte GJ. Thick vs. thin gingival biotypes: a key determinant in treatment planning for dental implants. J Calif Dent Assoc. 2008;36(3):193–8.
Chen ST, Buser D. Clinical and esthetic outcomes of implants placed in postextraction sites. Int J Oral Maxillofac Implants. 2009;24(Suppl):186–217.
Chen ST, Darby IB, Reynolds EC. A prospective clinical study of non-submerged immediate implants: clinical outcomes and esthetic results. Clin Oral Implants Res. 2007;18(5):552–62.
Kan JY, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. J Periodontol. 2003;74(4):557–62.
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(2):165–71.
Lin G-H, Chan H-L, Wang H-L. Effects of currently available surgical and restorative interventions on reducing midfacial mucosal recession of immediately placed single-tooth implants: a systematic review. J Periodontol. 2014;85(1):92–102.
Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla—a systematic review. Int J Oral Maxillofac Implants. 2014;29.(Suppl):186–215.
Funato A, Salama MA, Ishikawa T, Garber DA, Salama H. Timing, positioning, and sequential staging in esthetic implant therapy: a four-dimensional perspective. Int J Periodontics Restorative Dent. 2007;27(4):313–23.
Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19(7):43–61.
Choquet V, Hermans M, Adriaenssens P, Daelemans P, Tarnow DP, Malevez C. Clinical and radiographic evaluation of the papilla level adjacent to single-tooth dental implants. A retrospective study in the maxillary anterior region. J Periodontol. 2001;72(10):1364–71.
Tarnow D, Cho S, Wallace S. The effect of inter-implant distance on the height of inter-implant bone crest. J Periodontol. 2000;71(4):546–9.
Ramanauskaite A, Roccuzzo A, Schwarz F. A systematic review on the influence of the horizontal distance between two adjacent implants inserted in the anterior maxilla on the inter-implant mucosa fill. Clin Oral Implants Res. 2018;29:62–70.
Lang NP, Lindhe J. Clinical periodontology and implant dentistry, 2 Volume set. West Sussex, UK: Wiley; 2015.
Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol. 2000;5(1):119–28.
Merheb J, Vercruyssen M, Coucke W, Beckers L, Teughels W, Quirynen M. The fate of buccal bone around dental implants. A 12-month postloading follow-up study. Clin Oral Implants Res. 2017;28(1):103–8.
Buser D, Chappuis V, Kuchler U, Bornstein M, Wittneben J, Buser R, et al. Long-term stability of early implant placement with contour augmentation. J Dent Res. 2013;92(12_suppl):176S–82S.
Schwarz F, Giannobile W, Jung RE. Groups of the 2nd Osteology Foundation Consensus Meeting Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology Foundation Consensus Report Part 2—Effects of hard tissue augmentation procedures on the maintenance of peri-implant tissues. Clin Oral Implants Res 2018; Mar(29):11-13.
Peri-implant mucositis and peri-implantitis: a current understanding of their diagnoses and clinical implications. J Periodontol. 2013;84(4):436–43.
Hammerle C, Chen ST, Wilson TGJ. Consensus statements and recommended clinical procedures regarding the placement of implants in extraction sockets. Int J Oral Maxillofac Implants. 2004;19.(Suppl):26–8.
Kan JYK, Rungcharassaeng K, Deflorian M, Weinstein T, Wang HL, Testori T. Immediate implant placement and provisionalization of maxillary anterior single implants. Periodontology. 2018;2000
Kan JY, Rungcharassaeng K, Lozada JL, Zimmerman G. Facial gingival tissue stability following immediate placement and provisionalization of maxillary anterior single implants: a 2- to 8-year follow-up. Int J Oral Maxillofac Implants. 2011;26(1):179–87.
Cardaropoli G, Araujo M, Lindhe J. Dynamics of bone tissue formation in tooth extraction sites. J Clin Periodontol. 2003;30(9):809–18.
Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late? Periodontology. 2017;73(1):84–102.
Tarnow DP, Chu SJ, Salama MA, Stappert J, Christian F, Salama H, et al. Flapless postextraction socket implant placement in the esthetic zone: part 1. The effect of bone grafting and/or provisional restoration on facial-palatal ridge dimensional change-a retrospective cohort study. Int J Periodontics Restorative Dent. 2014;34(3):323–31.
Chappuis V, Engel O, Reyes M, Shahim K, Nolte L-P, Buser D. Ridge alterations post-extraction in the esthetic zone: a 3D analysis with CBCT. J Dent Res. 2013;92(12_suppl):195S–201S.
van Kesteren CJ, Schoolfield J, West J, Oates T. A prospective randomized clinical study of changes in soft tissue position following immediate and delayed implant placement. Int J Oral Maxillofac Implants. 2010;25(3):562–70.
Esposito M, Barausse C, Pistilli R, Jacotti M, Grandi G, Tuco L, et al. Immediate loading of post-extractive versus delayed placed single implants in the anterior maxilla: outcome of a pragmatic multicenter randomised controlled trial 1-year after loading. Eur J Oral Implantol. 2015;8(4):347–58.
Su H, González-Martín O, Weisgold A, Lee E. Considerations of implant abutment and crown contour: critical contour and subcritical contour. Int J Periodontics Restorative Dent. 2010;30(4):335–43.
Lops D, Bressan E, Parpaiola A, Sbricoli L, Cecchinato D, Romeo E. Soft tissues stability of cad-cam and stock abutments in anterior regions: 2-year prospective multicentric cohort study. Clin Oral Implants Res. 2015;26(12):1436–42.
The American Academy of Periodontology. Glossary of periodontal terms. Illinois, CA: American Academy of Periodontology; 2001.
Jemt T. Regeneration of gingival papillae after single-implant treatment. Int J Periodontics Restorative Dent. 1997;17(4):326–33.
Nordland WP, Tarnow DP. A classification system for loss of papillary height. J Periodontol. 1998;69(10):1124–6.
Schropp L, Isidor F. Clinical outcome and patient satisfaction following full-flap elevation for early and delayed placement of single-tooth implants: a 5-year randomized study. Int J Oral Maxillofac Implants. 2008;23(4):733–43.
Meijer HJ, Stellingsma K, Meijndert L, Raghoebar GM. A new index for rating aesthetics of implant-supported single crowns and adjacent soft tissues–the Implant Crown Aesthetic Index. Clin Oral Implants Res. 2005;16(6):645–9.
Fürhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44.
Belser UC, Grütter L, Vailati F, Bornstein MM, Weber H-P, Buser D. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2-to 4-year follow-up using pink and white esthetic scores. J Periodontol. 2009;80(1):140–51.
Juodzbalys G, Wang HL. Esthetic Index for Anterior Maxillary Implant-Supported Restorations. J Periodontol. 2010;81(1):34–42.
Bassetti M, Kaufmann R, Salvi GE, Sculean A, Bassetti R. Soft tissue grafting to improve the attached mucosa at dental implants: A review of the literature and proposal of a decision tree. Quintessence Int. 2015;46(6):499–510.
Benic GI, Wolleb K, Sancho-Puchades M, Hämmerle CH. Systematic review of parameters and methods for the professional assessment of aesthetics in dental implant research. J Clin Periodontol. 2012;39(s12):160–92.
Prato GPP, Cairo F, Tinti C, Cortellini P, Muzzi L, Mancini EA. Prevention of alveolar ridge deformities and reconstruction of lost anatomy: a review of surgical approaches. Int J Periodontics Restorative Dent. 2004;24(5):434–45.
Poskevicius L, Sidlauskas A, Galindo-Moreno P, Juodzbalys G. Dimensional soft tissue changes following soft tissue grafting in conjunction with implant placement or around present dental implants: a systematic review. Clin Oral Implants Res. 2017;28(1):1–8.
Burkhardt R, Joss A, Lang NP. Soft tissue dehiscence coverage around endosseous implants: a prospective cohort study. Clin Oral Implants Res. 2008;19(5):451–7.
Roccuzzo M, Gaudioso L, Bunino M, Dalmasso P. Surgical treatment of buccal soft tissue recessions around single implants: 1-year results from a prospective pilot study. Clin Oral Implants Res. 2014;25(6):641–6.
Zucchelli G, Mazzotti C, Mounssif I, Mele M, Stefanini M, Montebugnoli L. A novel surgical–prosthetic approach for soft tissue dehiscence coverage around single implant. Clin Oral Implants Res. 2013;24(9):957–62.
Zuhr O, Bäumer D, Hürzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol. 2014;41(s15):123–42.
Cairo F, Pagliaro U, Nieri M. Treatment of gingival recession with coronally advanced flap procedures: a systematic review. J Clin Periodontol. 2008;35(s8):136–62.
Thoma DS, Buranawat B, Hämmerle CH, Held U, Jung RE. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review. J Clin Periodontol. 2014;(s15):41, S77–S91.
Chung DM, Oh T-J, Shotwell JL, Misch CE, Wang H-L. Significance of keratinized mucosa in maintenance of dental implants with different surfaces. J Periodontol. 2006;77(8):1410–20.
Ten Bruggenkate C, Krekeler G, Van Der Kwast W, Oosterbeek H. Palatal mucosa grafts for oral implant devices. Oral Surg Oral Med Oral Pathol. 1991;72(2):154–8.
Bruschi GB, Crespi R, Capparé P, Gherlone E. Clinical study of flap design to increase the keratinized gingiva around implants: 4-year follow-up. J Oral Implantol. 2014;40(4):459–64.
Başeğmez C, Ersanlı S, Demirel K, Bölükbaşı N, Yalcin S. The comparison of two techniques to increase the amount of peri-implant attached mucosa: free gingival grafts versus vestibuloplasty. One-year results from a randomised controlled trial. Eur J Oral Implantol. 2012;5(2):139–45.
Basegmez C, Karabuda ZC, Demirel K, Yalcin S. The comparison of acellular dermal matrix allografts with free gingival grafts in the augmentation of peri-implant attached mucosa: a randomised controlled trial. Eur J Oral Implantol. 2013;6(2):145–52.
Lee K-H, Kim B-O, Jang H-S. Clinical evaluation of a collagen matrix to enhance the width of keratinized gingiva around dental implants. J Periodontal Implant Sci. 2010;40(2):96–101.
Thoma DS, Jung RE, Schneider D, Cochran DL, Ender A, Jones AA, et al. Soft tissue volume augmentation by the use of collagen-based matrices: a volumetric analysis. J Clin Periodontol. 2010;37(7):659–66.
Sanz M, Lorenzo R, Aranda JJ, Martin C, Orsini M. Clinical evaluation of a new collagen matrix (Mucograft® prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial. J Clin Periodontol. 2009;36(10):868–76.
Lorenzo R, García V, Orsini M, Martin C, Sanz M. Clinical efficacy of a xenogeneic collagen matrix in augmenting keratinized mucosa around implants: a randomized controlled prospective clinical trial. Clin Oral Implants Res. 2012;23(3):316–24.
Esposito M, Maghaireh H, Grusovin MG, Ziounas I, Worthington HV. Soft tissue management for dental implants: what are the most effective techniques? A Cochrane systematic review. Eur J Oral Implantol. 2012;5(3):221–38.
Thoma DS, Naenni N, Figuero E, Hämmerle CH, Schwarz F, Jung RE, et al. Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis. Clin Oral Implants Res. 2018;29:32–49.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Kelekis-Cholakis, A., Atout, R., Hamdan, N., Tsourounakis, I. (2018). Peri-implant Soft Tissue Deficiencies. In: Peri-Implant Complications. Springer, Cham. https://doi.org/10.1007/978-3-319-63719-8_2
Download citation
DOI: https://doi.org/10.1007/978-3-319-63719-8_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-63717-4
Online ISBN: 978-3-319-63719-8
eBook Packages: MedicineMedicine (R0)