title: Soft tissue management at implant sites.
abstract: BACKGROUND
  Dental implants are widely used to replace lost teeth. It was suggested that surgical manipulation/augmentation of peri-implant soft tissue may be beneficial to increase the width/thickness of keratinized tissue (KT) and to enhance aesthetic outcomes of implant therapy. The aim of this paper was to provide a narrative review of the literature concerning soft tissue management at implant sites.
  
  
  METHODS
  Clinical studies were identified with both medline and hand searches. Three topics were considered in this review: (i) the significance of KT at implant sites, (ii) the surgical techniques to increase KT and (iii) soft tissue stability around implants.
  
  
  RESULTS
  Several papers concerning soft tissue management at implant sites were identified, mainly expert opinions, case reports and case series. In addition, a systematic review was selected. Generally, the level of evidence was weak. So far, literature analysis showed that (i) the width of KT did not influence the survival rate of dental implants; (ii) there is no evidence to recommend a specific technique to preserve/augment KT; and (iii) factors including bone level, KT and implant features have not been shown to be associated with future mucosal recession around dental implants.
  
  
  CONCLUSIONS
  Although scientific evidence in most part is lacking, soft tissue augmentation at implant sites may need to be considered in some clinical situations.
authors: Department of Periodontology, University of Florence, Florence, Italy. cairofrancesco@virgilio.it
authors: Francesco
authors: F
authors: Cairo
authors: Umberto
authors: U
authors: Pagliaro
authors: Michele
authors: M
authors: Nieri
mesh_terms: D015921:Dental Implants; D004955:Esthetics, Dental; D005881:Gingiva / Q000637:transplantation; D005889:Gingival Recession / Q000517:prevention & control; D006801:Humans; D010519:Periodontium / Q000601:surgery*; D013524:Surgical Flaps
chemical_list: D015921:Dental Implants