Clinical and morphological aspects of the implant/soft tissue interface

Rodrigo F. Neiva, DDS(a) Kathleen G. Neiva, DDS,(b) Tae-Ju Oh, DDS, MS,a and Hom-Lay Wang, DDS, MSD(a)

(a)Department of Periodontics/Prevention/Geriatrics, and (b)Department of Cariology/ Restorative Science/Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA

This paper is aimed to describe clinical and morphological aspects of the soft tissue implant/soft tissue interface and to provide guidelines for assessment of peri-implant mucosal health.
Materials and Methods: Critical appraisal of the current literature regarding the interface between dental implants and the peri-implant mucosa is performed.
Results: The articles reviewed agree that smooth titanium surfaces are highly compatible with oral soft tissues. The biological seal that is formed by the mucosa surrounding dental implants is established to provide protection against microbial invasion. Implant design may influence the location of the biological seal, but not the formation of the seal. Non-keratinized peri-implant mucosa does not seem to predispose peri-implant disease. Keartinized mucosa seems to be desirable for hygiene procedures and esthetics, but not necessary for implant success. Assessment of peri-implant mucosal health has shown to be a predictable indicator of peri-implant disease.
Conclusion: Studies have consistently shown that biologic seal is formed between the oral cavity and the underlying tissues after implant placement, providing protection against the microbial challenge. However, future studies are needed in order to clarify the importance of the biological seal for implant success.
(Int Chin J Dent 2002; 2: 151-161.)
Clinical Significance: Since dental implant penetrate into the oral cavity, the interface between dental implants and oral soft tissues allows the formation of a biologic seal. This biologic seal has the ability to protect the underneath structures by closing the pathway of communication between the oral environment and the alveolar bone. Assessment of the integrity of this interface aids in early detection of peri-implant pathologies, and may prevent future implant bone loss. In addition, the implant/soft tissue interface may provide esthetics that implant supported restoration needs.
Key Words: biological width, dental implants, mucositis, peri-implant mucosa.