Periodontal considerations in implant therapy

Yi-Pin Tsao, DDS, and Hom-Lay Wang, DDS, MSD

Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA

Purpose: This paper is aimed to address periodontal considerations around dental implants. Tools used to identify disease/infection and techniques developed to correct peri-implant infection were thoroughly discussed. Procedures that have been successful used in maintaining/correcting soft/hard tissue problems around dental implants were explored.
Materials and Methods: Critical appraisal of the current techniques regarding the soft/hard tissue grafts is performed. Techniques that have shown predictable outcomes were selected and discussed. Guidelines for treating peri-implant infection and dealing with different soft/hard tissue defects were provided.
Results: Peri-implant infection can be early identified and treated. Ridge preservation as well as guided bone regeneration prior to implant placement had been widely adopted as the predictable treatment methods. Soft tissue grafting such as connective tissue graft, ovate pontic site development, and other common soft tissue grafts (e.g., roll, pouch, interpositional grafts, onlay grafts and combination grafts) can be successfully applied in augmenting peri-implant tissue height and width while achieving esthetics around dental implants. In addition, implant maintenance care is necessary for the overall success.
Conclusion: To maintain implant long-term success, the interface between soft and hard tissues should be clearly understood. Several procedures such as ridge preservation and guided bone regeneration have shown promising results in restoring/maintaining the alveolar bone height and width to facilitate ideal implant placement. Many soft tissue grafts, for example connective tissue graft, have been used to augment soft tissue thickness while provide esthetic results around dental implants.
(Int Chin J Dent 2003; 3: 13-30.)

Clinical Significance
: This paper provides ways of maintaining/correcting soft/hard tissue defects around dental implants.
Key Words: dental implant, guided bone regeneration, implant maintenance, implant plastic surgery, peri-implant mucosa, soft tissue graft.