The Impact of Peri-implant Soft Tissue Properties on Patient-reported and Clinically Assessed Outcomes: A Prospective Study.
Abstract: Aim & Hypothesis: There is no agreement on the minimal amount of keratinized mucosa (KM) that is needed around dental implants and, therefore, whether augmentation techniques in the absence of KM are recommended. While some authors recommend mucogingival procedures for patients who have discomfort during brushing at the implant site or to obtain satisfactory esthetic results, no study ... read morehas systematically assessed and compared discomfort during brushing, patient peri-implant soft tissue esthetic satisfaction (TES) and other clinical parameters between implants with and without KM. The aim of this study was to evaluate the discomfort while performing oral hygiene around implants with and without KM and to assess the TES and other clinical parameters 3 months after crown delivery. Materials & Methods: Group 1 consisted of subjects with implants surrounded by KM at the time of second stage surgery, and group 2 subjects with implants without KM. Discomfort during brushing was measured 3 months after crown delivery by means of a validated visual analogue scale (VAS). The outcomes were then compared in the 2 groups using Mann-Whitney test. In addition, plaque index (PI), bleeding on probing (BoP), pocket depth (PD), peri-implant recession (REC), and VAS for TES were recorded. Results: Nineteen subjects completed the study, 12 in group 1 and 7 in group 2. There was a statistically significant difference in the 2 groups in terms of PI at the mid-buccal site (P = 0.02) and VAS for TES (P = 0.03). In addition, a trend toward significance was reported for BoP at the mid-buccal site (P = 0.10), BoP at the disto-buccal site (P = 0.15), PD at the mesio-buccal site (P = 0.10), and REC at the mid-buccal site (P = 0.06). Conclusions: The preliminary data obtained in this study show that subjects rehabilitated with dental implants surrounded by AM reported less esthetic satisfaction in regard to their peri-implant soft tissues. In addition, those sites had more plaque accumulation on the mid-buccal aspect and showed a tendency to higher bleeding on probing, pocket depth and peri-implant recession. Further investigation will need to confirm these findings ultimately allowing specific treatment recommendations.
Thesis (M.S.)--Tufts University, 2015.
Submitted to the Dept. of Periodontology.
Advisor: Hans-Peter Weber.
Committee: Bjorn Steffensen, Yong Hur, and Jennifer Bassett Midle.
Keyword: Dentistry.read less