Principles and mechanisms of peri-implant soft tissue healing.
The long-term clinical and esthetic success of implant-supported restorations is determined by osseointegration and optimal remodeling of peri-implant soft tissues. Complications of soft-tissue management are often caused by fibrotic regeneration of oral mucosa after multiple surgical procedures. Knowledge of the proliferative processes in wound healing is necessary to attain adequate soft-tissue conditions. Successful reconstruction of peri-implant soft tissues is feasible even in fibrotic conditions when appropriate surgical techniques are selected. The pleiotropic proliferative cytokine TGF-beta is involved in the regulation of all phases of wound healing and tissue remodeling. The isoform TGF-beta1 is a cytokine associated with the development of fibrotic tissue. Overexpression of TGF-beta1 causes scarring and fibrosis, and results in limited clinical success of intraoral soft-tissue management. Experimental therapeutic approaches with neutralizing antibodies to block TGF-beta1 resulted in less scarring and a reduction of fibrosis. Further molecular biologic research of cell-matrix-cytokine interactions in wound healing will provide highly specific antifibrotic therapeutic approaches in the future.
Schultze-Mosgau
Stefan
S
Clinic and Policlinic of Oral and Maxillofacial Surgery, Friedrich-Schiller-University Jena, Germany.
Blatz
Markus B
MB
Wehrhan
Falk
F
Schlegel
Karl Andreas
KA
Thorwart
Michael
M
Holst
Stefan
S
D002921:Cicatrix / Q000503:physiopathology; D015921:Dental Implants; D005355:Fibrosis; D006801:Humans; D016348:Osseointegration / Q000502:physiology; D010519:Periodontium / Q000503:physiopathology* / Q000601:surgery; D016212:Transforming Growth Factor beta / Q000037:antagonists & inhibitors / Q000502:physiology; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
D015921:Dental Implants; D016212:Transforming Growth Factor beta