Impact of Soft tissue Phenotype on dental implant contours and health

The soft tissue phenotype around dental implants is comprised of keratinized mucosa width (KMH), mucosal thickness(MT) and supra-crestal tissue height(STH).1,2 The type of soft tissue profile around dental implants affects the overall health of the implant as well as its esthetics. Implants with thin soft tissue phenotype are often prone to recession defects, and the mucosal tissue around them is insufficient to be able to cover some of the metal components that can show through tissue and be unesthetic, they are also prone to having incomplete papilla fill. The exposed sites can often be difficult to maintain and as a result, they are prone to bacterial accumulation and inflammation.

The goal when this occurs is soft tissue augmentation which is now used as a rescue procedure. The goal would be to convert the implant phenotype from a thin to thick soft tissue phenotype. This is performed through use of coronally or apically positioned flaps in combination with connective tissue grafts, free gingival grafts or acellular dermal grafts. The change in soft tissue phenotype is often invaluable for the overall health and esthetics around dental implants especially in the anterior zone. The grafting procedure now affords a soft tissue profile that not only helps maintain health around the implant site but also provide tissue around it that is more resistant to infection as well as enhances esthetics around the implant.

References:
1) Tavelli L, Barotchi S, Avita-Ortiz G, Urban IA, Giannobile WV, and Wang HL. Periimplant soft tissue phenotype modification and it impact on periimplant Health. A systematic review and network meta-analysis. J of Periodontology 2021(Jan);92(1): 21-44.
2) Wang IC, Barootchi S, Tavelli L, Wang HL. The Peri-Implant phenotype and implant esthetic complications. Contemporary overview. J of Esthetic and Restorative dentistry 2021 (Jan):1-12.