MUCOSAL CONSIDERATIONS FOR OSSEOINTEGRATED IMPLANTS

Tissue resistance is determined by the nature of cells and intercellul ar contacts irrespective of the presence or absence of keratinization, masticatory mucosa, or skin. However, these tissues are more easily m aintained and less vulnerable to inflammation when in contact with den tal implants. Lack of masticatory mucosa and the presence of alveolar mucosa embracing the implant are often associated with plaque, which c an induce inflammation resulting in subsequent peri-implant destructio n. To facilitate proper mechanical oral hygiene maintenance, transplan tation of autogenous masticatory mucosal grafts at the implant sites w as performed in patients without attached gingiva, unfavorable vestibu lum with submucosal muscular activity, and uncontrolled peri-implant m ucositis. The rationale for having attached mucosa around osseointegra ted implants and illustration of possible methods of mucosal managemen t in the different phases of implant rehabilitation are presented.