Soft tissue management around dental implants

Abstract

Soft tissue augmentation around dental implants is an essential component in modern implant dentistry, focusing on improving both functional and esthetic outcomes. This thesis investigates the efficacy of connective tissue grafts (CTG) and other soft tissue augmentation techniques on peri-implant soft tissue thickness, keratinized mucosa width, marginal bone levels (MBL), esthetic results, and patient satisfaction. A systematic review of nine clinical studies was conducted, supplemented with insights from broader scientific literature, to explore the outcomes of these interventions across diverse clinical scenarios.

The findings emphasize that soft tissue augmentation effectively increases peri-implant mucosal thickness and keratinized mucosa width, significantly reducing the risk of mucosal recession. These benefits are particularly pronounced in patients with thin mucosal biotypes or esthetically demanding regions. The study identifies critical soft tissue dimensions, including a minimum mucosal thickness of 2.5 mm and ≥2 mm of keratinized mucosa, as essential benchmarks for peri-implant health, esthetics, and stability. Furthermore, CTG demonstrated superior performance compared to alternative techniques, especially in cases with thin biotypes and immediate implant placement.

However, the study highlights the limited impact of soft tissue augmentation on MBL, raising questions about the relationship between mucosal thickness and bone stability. While esthetic parameters such as Pink Esthetic Scores (PES) and patient satisfaction were significantly improved, the variation in patient-centered outcomes indicates a need for further research.

This thesis provides scientific and clinical insights to support the development of evidence-based guidelines for soft tissue management in implant dentistry. Future research should focus on long-term outcomes, the role of alternative materials, and minimally invasive techniques to enhance peri-implant health and esthetic outcomes further.