Keratinized Tissue Assessment for Dental Implant Therapy| Stephy Publishers

 


SOJ Dental and Oral Disorder - (SOJDOD)| Stephy Publishers


Editorial
Although overall failure rates in implant dentistry are low,1 peri-implant diseases have been recognized as a common biologic complication that can reduce the long-term success of dental implants.2 A recent systematic review and meta-analysis reported prevalence of peri-implant mucositis and peri-implantitis to be at 65% and 47%, respectively.3 Peri-implant mucositis and peri-implantitis are biofilm-associated, inflammatory conditions of peri-implant tissues.4 There has been significant evidence implying the role of bacterial plaque in the initiation of inflammatory responses in the gingiva of natural teeth as well as peri-implant mucosa.5,6 Peri-implant disease etiology is multi factorial in nature,7 and numerous factors may contribute to plaque accumulation and subsequent inflammation, playing a role as risk indicators for the development of peri-implant disease.2,8,9 The anatomy and histology of the mucosal attachment around dental implants is considerably different from that around natural teeth.10,11 A direct anchorage of the connective tissue to the implant surface is not possible due the absence of periodontal ligament and cementum as seen in natural teeth. Instead, collagen fibers run parallel to the implant surface and the mechanical quality of this attachment is low.

On a biologic level, it would be favorable to have a zone of keratinized tissue around dental implants. However, the need for keratinized tissue around implants is highly debated. There have been several studies which have documented positive associations between the presence of adequate keratinized mucosa around implants and improved soft tissue health.12–14 Further, the lack of keratinized tissue around implants has been demonstrated to make the peri-implant region more susceptible to plaque-induced tissue destruction.


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