Importance of Keratinized Tissues Around Implants: Can They Help in the Prevention of Peri-implant Diseases?

Abstract Body: Although not supported by the literature, it is often assumed that the presence of less than 2mm of keratinized tissue around implants impedes adequate oral hygiene measures and provides limited protection from mechanical trauma and microbial invasion of the peri-implant pocket. Structural and anatomical differences in implants compared to natural teeth make them more susceptible to the development of inflammation, therefore, clinicians often perform soft tissue augmentation procedures to increase the thickness of the keratinized tissue. Whether the presence or absence of keratinized mucosa can affect the long term stability of peri-implant tissues has been an issue much debated over the last few decades. In general, the amount of keratinized tissue, doesn’t seem to have a significant effect on the amount of average annual bone loss around a dental implant but there is an indication that it can be advantageous in reducing plaque accumulation, inflammation and gingival recession. Overall, it seems that peri-implant health can be maintained irrespective of the width of the keratinized tissue when oral hygiene is optimal.