Basic Dental Implantology (Midterms)
IMPLANT SOFT TISSUE
CONSIDERATIONS - 09/25/24
● Peri-implant Mucosa
● Gingival Biotypes
● Aesthetic Predictability
● Perio-Plastic Surgery
The health and vitality of an osseointegrated
implant depends on the surrounding
supporting tissues, which not only anchor
the implant to the bone but also have the
important function of providing a protective ● Proliferative capacity of the
seal. junctional epithelium leads to the
rapid migration of the epithelial cells
● Peri-implant mucosa is composed of ● Indirect epithelium-to-implant contact
well-keratinized oral epithelium, ● Presence of granulation tissue
sulcular epithelium, and junctional adhering to the surface of the
epithelium, as well as underlying transmucosal components
connective tissue.
● Between the implant surface and the
epithelial cells are hemidesmosomes
and basal lamina.
● includes the biologic zone known as
the "biologic width,"
● Formation and adhesion of the fibrin
clot to the implant surface
● Adsorption of the fibrin clot to the
implant surface
● Adsorption of the extracellular matrix
(ECM) proteins and connective
tissue cells to the implant surface
● Transformation of the clot into
granulation tissue
● Migration of epithelial cells on top of
the fibrin clot/granulation tissue.
, Basic Dental Implantology (Midterms)
Implant Soft Tissue Probing
● Peri-implant probing provides an
assessment of different parameters
such as bleeding on probing,
suppuration, and exudation from the
sulcus and peri-implant tissues.
● Studies have shown that, when
used, probe pressure of 0.5 N
penetrates an average of 0.7 mm
deeper at implant sites.
● Clinical probing depth is higher
around implants versus teeth, as the
probe tip ends apically to the
● The connective tissue zone next to junctional epithelium into the
the implant surface is primarily connective tissue close to the bone
divided into two parts: crest.
● The first is a 50-um inner zone that ● Bleeding on probing is a more
is rich in fibers; resembling scar reliable sign of inflammation around
tissue, several scattered fibroblasts a tooth but is less reliable around
in close contact with the titanium implants.
surface maintain the seal between ● Probing depth penetration around
the peri-implant bone and the oral teeth has been found to be < 3 mm
environment as opposed to 2.5 mm to 4 mm
● The remaining part of the connective around implants.
tissue comprises fibers running in
different directions, along with the
cellular elements and blood vessels.
Connective tissue cells and the
collagen fiber bundles are separated
from the TiO2 surface with a
20-nm-wide proteoglycan layer.
IMPLANT SOFT TISSUE
CONSIDERATIONS - 09/25/24
● Peri-implant Mucosa
● Gingival Biotypes
● Aesthetic Predictability
● Perio-Plastic Surgery
The health and vitality of an osseointegrated
implant depends on the surrounding
supporting tissues, which not only anchor
the implant to the bone but also have the
important function of providing a protective ● Proliferative capacity of the
seal. junctional epithelium leads to the
rapid migration of the epithelial cells
● Peri-implant mucosa is composed of ● Indirect epithelium-to-implant contact
well-keratinized oral epithelium, ● Presence of granulation tissue
sulcular epithelium, and junctional adhering to the surface of the
epithelium, as well as underlying transmucosal components
connective tissue.
● Between the implant surface and the
epithelial cells are hemidesmosomes
and basal lamina.
● includes the biologic zone known as
the "biologic width,"
● Formation and adhesion of the fibrin
clot to the implant surface
● Adsorption of the fibrin clot to the
implant surface
● Adsorption of the extracellular matrix
(ECM) proteins and connective
tissue cells to the implant surface
● Transformation of the clot into
granulation tissue
● Migration of epithelial cells on top of
the fibrin clot/granulation tissue.
, Basic Dental Implantology (Midterms)
Implant Soft Tissue Probing
● Peri-implant probing provides an
assessment of different parameters
such as bleeding on probing,
suppuration, and exudation from the
sulcus and peri-implant tissues.
● Studies have shown that, when
used, probe pressure of 0.5 N
penetrates an average of 0.7 mm
deeper at implant sites.
● Clinical probing depth is higher
around implants versus teeth, as the
probe tip ends apically to the
● The connective tissue zone next to junctional epithelium into the
the implant surface is primarily connective tissue close to the bone
divided into two parts: crest.
● The first is a 50-um inner zone that ● Bleeding on probing is a more
is rich in fibers; resembling scar reliable sign of inflammation around
tissue, several scattered fibroblasts a tooth but is less reliable around
in close contact with the titanium implants.
surface maintain the seal between ● Probing depth penetration around
the peri-implant bone and the oral teeth has been found to be < 3 mm
environment as opposed to 2.5 mm to 4 mm
● The remaining part of the connective around implants.
tissue comprises fibers running in
different directions, along with the
cellular elements and blood vessels.
Connective tissue cells and the
collagen fiber bundles are separated
from the TiO2 surface with a
20-nm-wide proteoglycan layer.
