THE SOFT-TISSUE RESPONSE TO OSSEOINTEGRATED DENTAL IMPLANTS

The use of dental implants in the treatment of fully edentulous patien ts has become an important addition in oral/dental rehabilitation. The fact that these implants penetrate the oral mucosa can lead to the as sumption that peri-implant tissues, similar to the periodontal tissues , are fulfilling an important function as a barrier to protect the bon y anchorage underneath. It has been shown that insufficient plaque rem oval may lead to peri-implant tissue disease with bone loss similar to teeth. However, it is unclear how important this cause is as a source of implant failure compared with other factors, such as inadequate bo ne healing, unfavorable quantity and quality of bone, or (bio)mechanic al and functional problems. It is also not understood if peri-implant epithelium and connective tissue are equally needed and/or qualified t o slow down or prevent tissue breakdown as their periodontal counterpa rts. The scientific work focusing on peri-implant soft tissues has dra matically increased in the past few years. Most studies to date have e xamined and described their structure but little data exist on their t rue biologic function. This review analyzes the current understanding of morphologic and clinical features of the peri implant soft tissues. Furthermore, evidence shall be provided that peri-implant soft tissue s do not interfere with the current favorable results obtained when tr eating the edentulous patient with osseointegrated implants.