To evaluate the role of keratinized mucosa around dental implants, correlating with other clinical parameters related to the success of dental implants.
Design
Cross-section.
Setting
Institutional tertiary referral hospital.
Patients
A total of 202 dental implants fixed in the cleft area of 109 patients with cleft lip and/or palate were evaluated.
Interventions
The evaluated clinical parameters were probing depth and gingival and plaque indexes on the buccal surface (three sites).
Main Outcome Measures
All clinical parameters were correlated with the width of keratinized mucosa around the implants.
Results
The largest probing depths were detected when the width of keratinized mucosa was 2 mm or more, with a statistically significant difference between the means of the probing depth and keratinized mucosa width.
Conclusion
Even though the present results suggest that peri-implant health can be observed in areas with keratinized mucosa width under 2 mm provided an adequate oral hygiene control is performed, longitudinal randomized studies are necessary to analyze the relationship between the width of keratinized mucosa and the health of peri-implant tissues.
AbrahamssonI., BerglundhT., WennströmJ., LindheJ.The peri-implant hard and soft tissues at different implant systems. A comparative study in the dog.Clin Oral Implants Res.1996; 7: 212–219.
2.
AdellR., LekholmU., RockierB., BranemarkP.I.A 15-year study of osseointegrated implants in the treatment of the edentulous jaw.Int J Oral Surg.1981; 10: 387–416.
3.
AdibradM., ShahabueiM., SahabiM.Significance of the width of keratinized mucosa on the health status of the supporting tissue around implants supporting overdentures.J Oral Implantol.2009; 35: 232–237.
4.
AlmeidaALPF, PereiraT., SiqueiraA.F., CarrilhoG.P.B., GreghiS.L.A., ResendeD.R.B.Periodontal health re-establishment in cleft lip and palate patients through vestibuloplasty associated with free gingival graft.Perio.2005; 2: 23–29.
5.
AlpertA.A rationale for attached gingiva at the soft-tissue/implant interface: esthetic and functional dictates.Compendium.1994; 15: 356–368.
6.
BeckerW., BeckerB.E., NewmanM.G., NymanS.Clinical and microbiologic findings that may contribute to dental implant failure.Int J Oral Maxillofac Implants.1990; 5: 31–38.
7.
BerglundhT., LindheJ.Dimension of the periimplant mucosa. Biological width revisited.J Clin Periodontal.1996; 23: 971–973.
8.
BowersG.M.A study of the width of attached gingiva.J Periodontal.1963; 34: 201–209.
9.
BoyneP.J., SandsN.R.Secondary bone grafting of residual alveolar and palatal clefts.J Oral Surg.1972; 30: 87–92.
10.
ChungD.M., OhT.J., ShotwellJ.L., MischC.E., WangH.L.Significance of keratinized mucosa in maintenance of dental implants with different surfaces.J Periodontal.2006; 77: 1410–1420.
11.
CoxJ.F., ZarbG.A.The longitudinal clinical efficacy of osseointegrated dental implants: a 3-year report.Int J Oral Maxillofac Implants.1987; 2: 91–100.
12.
DeepeH., HorchH.H., KolkA.Microstructured dental implants and palatal mucosal grafts in cleft patients: a retrospective analysis.J Craniomaxillofac Surg.2004; 32: 211–215.
13.
de TreyE., BernimoulinJ.P.Influence of free gingival grafts on the health of the marginal gingiva.J Clin Periodontal.1980; 7: 381–393.
14.
EerensK., VlietinckR., HeidbüchelK., Van OlmenA., DeromC., WillemsG., CarelsC.Hypodontia and tooth formation in groups of children with cleft, siblings without cleft, and nonrelated controls.Cleft Palate Craniofac J.2001; 38: 374–378.
15.
EricssonI., BerglundhT., MarinelloC., LiljenbergB., LindheJ.Longstanding plaque and gingivitis at implants and teeth in the dog.Clin Oral Implants Res.1992; 3: 99–103.
16.
EricssonI., LindheJ.Probing depth at implants and teeth. An experimental study in the dog.J Clin Periodontal.1993; 20: 623–627.
17.
GagglA., SchultesG., KärcherH., MossböckR.Periodontal disease in patients with cleft palate and patients with unilateral and bilateral clefts of lip, palate, and alveolus.J Periodontal.1999; 70: 171–178.
HärtelJ., PöglC., HenkelK.O., GundlachK.K.Dental implants in alveolar cleft patients: a retrospective study.J Craniomaxillofac Surg.1999; 27: 354–357.
20.
KarbachJ., CallawayA., KwonY.D., d'HoedtB., Al-NawasB.Comparison of the five parameters as risk factors for peri-mucositis.Int J Oral Max Implants.2009; 24: 491–496.
21.
LangN.P., LöeH.The relationship between the width of keratinized gingiva and gingival health.J Periodontal.1972; 43: 623–627.
22.
LindheJ., BerglundhT.The interface between the mucosa and the implant.Periodontal 2000.1998; 17: 47–54.
23.
LindheJ., BerglundhT., EricssonI., LiljenbergB., MarinelloC.Experimental breakdown of peri-implant and periodontal tissues. A study in the beagle dog.Clin Oral Implants Res.1992; 3: 9–16.
24.
LöeH.(1967). The gingival index, the plaque index and the retention index systems.J Periodontal.1967; 38: 610–616.
25.
MaynardJGJr., WilsonR.D.Physiologic dimensions of the periodontium significant to the restorative dentist.J Periodontal.1979; 50: 170–174.
26.
MiyasatoM., CriggerM., EgelbergJ.Gingival condition in areas of minimal and appreciable width of keratinized gingiva.J Clin Peri odontal.1977; 4: 200–209.
27.
NewmanM.G., FlemmigT.F.Periodontal considerations of implants and implant associated microbiota.J Dent Educ.1988; 52: 737–744.
28.
OpitzC., MeierB., StollC., SubklewD.Radiographic evaluation of the transplant bone height in patients with clefts of the lip/alveolus/palate after secondary bone grafting.J Orofac Orthop.1999; 60: 383–391.
29.
RantaR.A review of tooth formation in children with cleft lip/palate.Am J Orthod Dentofacial Orthop.1996; 90: 11–18.
StetlerK.J., BissadaN.F.Significance of the width of keratinized gingiva on the periodontal status of teeth with submarginal restorations.J Periodontal.1987; 58: 696–700.
34.
StrubJ.R., GaberthüelT.W., GrunderU.The role of attached gingiva in the health of peri-implant tissue in dogs. 1. Clinical findings.Int J Periodontics Restorative Dent.1991; 11: 317–333.
35.
Ten BruggencateC.M., KrekelerG., Van Der KwastW., OosterbeekH.S.Palatal mucosal grafts for oral implant devices.Oral Surg Oral Med Oral Pathol.1991; 72: 154–158.
36.
ValderhaugJ.Periodontal conditions and carious lesions following the insertion of fixed prostheses: a 10-year follow-up study.Int Dent J.1980; 30: 296–304.
37.
WarrerK., BuserD., LangN.P., KarringT.Plaque-induced peri-implantitis in the presence or absence of keratinized mucosa. An experimental study in monkeys.Clin Oral Implants Res.1995; 6: 131–138.
38.
WennströmJ.L., BengaziF., LekholmU.The influence of the masticatory mucosa on the peri-implant soft tissue condition.Clin Oral Implants Res.1994; 5: 1–8.
39.
ZarbG.A., SymingtonJ.M.Osseointegrated dental implants: preliminary report on a replication study.J Prosthet Dent.1983; 50: 271–276.
40.
ZigdonH., MachteiE.E.The dimensions of keratinized mucosa around implants affect clinical and immunological parameters.Clin Oral Implant Res.2008; 19: 387–392.
