Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans.

BACKGROUND Attempts have been made to evaluate the biologic dimension of osseointegrated implants, however, most are histologic studies in animals, and the effect of soft tissue support from adjacent teeth on the interproximal dimension of the peri-implant mucosa for anterior single implants has not been addressed. This study clinically evaluated the dimensions of the peri-implant mucosa around 2-stage maxillary anterior single implants in humans after 1 year of function. The influence of the peri-implant biotype was also examined. METHODS Forty-five patients (20 males and 25 females) with a mean age of 47.3 years were included in this study. A total of 45 maxillary anterior single implant crowns with a mean functional time of 32.5 months (range, 12 to 78) were evaluated. The dimensions of peri-implant mucosa were measured by bone sounding using a periodontal probe at the mesial (MI), mid-facial (F), and distal (DI) aspects of the implant restoration and the proximal aspects (MT, DT) of adjacent natural teeth. In addition, the peri-implant biotype was evaluated and categorized as thick or thin. Statistical analysis was performed using an independent t test (P<0.05). RESULTS The means and standard deviations of the dimensions of peri-implant mucosa at MT, MI, F, DI, and DT were 4.20 +/- 0.77 mm, 6.17 +/- 1.27 mm, 3.63 +/- 0.91 mm, 5.93 +/- 1.21 mm, and 4.20 +/- 0.64 mm, respectively. The dimensions of peri-implant mucosa in the thick biotype were significantly greater than the thin biotype at MT, MI, and DT (P<0.05). CONCLUSIONS The mean facial dimension of peri-implant mucosa of 2-stage implants is slightly greater than the average dimension of the dentogingival complex. The level of the interproximal papilla of the implant is independent of the proximal bone level next to the implant, but is related to the interproximal bone level next to the adjacent teeth. Greater peri-implant mucosal dimensions were noted in the presence of a thick peri-implant biotype as compared to a thin biotype.

[1]  C J Goodacre,et al.  Clinical complications of osseointegrated implants. , 1999, The Journal of prosthetic dentistry.

[2]  J C Kois,et al.  Aesthetic peri-implant site development. The restorative connection. , 1998, Dental clinics of North America.

[3]  L. Cooper,et al.  A multicenter 12-month evaluation of single-tooth implants restored 3 weeks after 1-stage surgery. , 2001, The International journal of oral & maxillofacial implants.

[4]  T. Jemt.  Restoring the gingival contour by means of provisional resin crowns after single-implant treatment. , 1999, The International journal of periodontics & restorative dentistry.

[5]  R. James.  Peri-implant considerations. , 1980, Dental clinics of North America.

[6]  James Ra.  Peri-implant considerations. , 1980 .

[7]  D. Cochran,et al.  Biologic Width around one- and two-piece titanium implants. , 2001, Clinical oral implants research.

[8]  A. Weisgold,et al.  Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult. , 1977, The Alpha omegan.

[9]  L. Rose,et al.  The "biologic width"--a concept in periodontics and restorative dentistry. , 1977, The Alpha omegan.

[10]  Ingber Js,et al.  The "biologic width"--a concept in periodontics and restorative dentistry. , 1977 .

[11]  U. Velden.  Regeneration of the interdental soft tissues following denudation procedures , 1982 .

[12]  Weisgold As.  Contours of the full crown restoration. , 1977 .

[13]  J. Lindhe,et al.  On the relationship between crown form and clinical features of the gingiva in adolescents. , 1993, Journal of clinical periodontology.

[14]  L. Rose,et al.  Biologic width and its relation to periodontal biotypes. , 1998, Journal of esthetic dentistry.

[15]  Anthony W. Gargiulo,et al.  Dimensions and Relations of the Dentogingival Junction in Humans , 1961 .

[16]  H. Salama,et al.  Immediate total tooth replacement. , 2001, Compendium of continuing education in dentistry.

[17]  W. Gropp,et al.  Does increased aromatase activity in adipose fibroblasts cause low sexual desire in patients with HIV lipodystrophy? , 2002, Sexually transmitted infections.

[18]  M. Ash,et al.  Wheeler's Dental Anatomy, Physiology and Occlusion , 1992 .

[19]  W. Becker,et al.  Alveolar bone anatomic profiles as measured from dry skulls. Clinical ramifications. , 1997, Journal of clinical periodontology.

[20]  A. C. Richardson,et al.  The dimensions of the human dentogingival junction. , 1994, The International journal of periodontics & restorative dentistry.

[21]  N. Lang,et al.  Surgical lengthening of the clinical crown. , 1992, Journal of clinical periodontology.

[22]  Spear Fm.  Maintenance of the interdental papilla following anterior tooth removal. , 1999 .

[23]  J. Fiorellini,et al.  Soft tissue reactions to non-submerged unloaded titanium implants in beagle dogs. , 1992, Journal of periodontology.

[24]  K. Rungcharassaeng,et al.  Interimplant papilla preservation in the esthetic zone: a report of six consecutive cases. , 2003, The International journal of periodontics & restorative dentistry.

[25]  A. Heinecke,et al.  Masticatory mucosa in subjects with different periodontal phenotypes. , 2000, Journal of clinical periodontology.

[26]  J. Fiorellini,et al.  Comparison of healed tissues adjacent to submerged and non-submerged unloaded titanium dental implants. A histometric study in beagle dogs , 1996 .

[27]  A. Heinecke,et al.  Ultrasonic determination of gingival thickness. Subject variation and influence of tooth type and clinical features. , 1996, Journal of clinical periodontology.

[28]  N. Lang,et al.  Plaque-induced peri-implantitis in the presence or absence of keratinized mucosa. An experimental study in monkeys. , 1995, Clinical oral implants research.

[29]  J. Lindhe,et al.  Periodontal characteristics in individuals with varying form of the upper central incisors. , 1991, Journal of clinical periodontology.

[30]  U. van der Velden.  Regeneration of the interdental soft tissues following denudation procedures. , 1982, Journal of clinical periodontology.

[31]  John C. Kois,et al.  Altering Gingival Levels: The Restorative Connection Part I: Biologic Variables , 1994 .

[32]  J. Lindhe,et al.  Dimension of the periimplant mucosa. Biological width revisited. , 1996, Journal of clinical periodontology.

[33]  J. Wennström,et al.  Implant supported single-tooth replacements compared to contralateral natural teeth. Crown and soft tissue dimensions. , 1999, Clinical oral implants research.

[34]  D. Tarnow,et al.  The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. , 1992, Journal of periodontology.

[35]  D. E. Smith,et al.  Criteria for success of osseointegrated endosseous implants. , 1989, The Journal of prosthetic dentistry.

[36]  D Buser,et al.  Biologic width around titanium implants. A histometric analysis of the implanto-gingival junction around unloaded and loaded nonsubmerged implants in the canine mandible. , 1997, Journal of periodontology.

[37]  T Jemt,et al.  Regeneration of gingival papillae after single-implant treatment. , 1997, The International journal of periodontics & restorative dentistry.

[38]  J. Wennström.  Mucogingival considerations in orthodontic treatment. , 1996, Seminars in orthodontics.

[39]  D E Steflik,et al.  Evidence for a junctional epithelial attachment to ceramic dental implants. A transmission electron microscopic study. , 1985, Journal of periodontology.

[40]  J. Wennström,et al.  Recession of the soft tissue margin at oral implants. A 2-year longitudinal prospective study. , 1996, Clinical oral implants research.

[41]  J. Lindhe,et al.  Peri-implant tissues at submerged and non-submerged titanium implants. , 1999, Journal of clinical periodontology.

[42]  H. Hansson,et al.  Structural aspects of the interface between tissue and titanium implants. , 1983, The Journal of prosthetic dentistry.

[43]  J. Wennström,et al.  The peri-implant hard and soft tissues at different implant systems. A comparative study in the dog. , 1996, Clinical oral implants research.

[44]  John C Kois,et al.  Predictable single-tooth peri-implant esthetics: five diagnostic keys. , 2001, Compendium of continuing education in dentistry.