title: Necessity of keratinized tissues for dental implants: a clinical, immunological, and radiographic study.
abstract: BACKGROUND
  Necessity of keratinized tissues (KTs) for maintaining health around dental implants (DIs) remains as a controversial issue.
  
  
  OBJECTIVE
  The aim of this study was to investigate the effects of KT width (KTW) on peri-implant tissues by evaluating peri-implant clinical and inflammatory parameters.
  
  
  METHODS
  Sixty DIs were included in this 6-month longitudinal study. After classifying DI based on the presence of KTs at the buccal aspect as with adequate/inadequate KTW, DIs were randomly assigned into three study groups. In the first group, while free gingival graft (FGG) was performed, DIs in maintenance (M) group were followed up by standardized maintenance procedures at baseline, first, third, and sixth months as with DI with adequate KTW (Control). Clinical parameters, peri-implant sulcular fluid (PISF) volume, PISF Interleukin 1β concentration, and bone loss were analyzed.
  
  
  RESULTS
  Significant improvements in clinical and immunological parameters were noted only for FGG for the whole study period. Statistical differences detected between the treatment groups (FGG vs M) were for gingival index at all time points and for PISF volume at sixth month. For the other parameters evaluated, while lower values were observed for FGG, statistically no differences were noted between the groups.
  
  
  CONCLUSIONS
  Based on the results of this study, it can be suggested that FGG performed around DIs lacking KT is a reliable method, leading to significant improvements in clinical and inflammatory parameters. Further long-term studies including more DIs are needed to clarify the role of KT on maintenance of DIs.
authors: Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
authors: Sezen
authors: S
authors: Buyukozdemir Askin
authors: Ezel
authors: E
authors: Berker
authors: Hakan
authors: H
authors: Akincibay
authors: Serdar
authors: S
authors: Uysal
authors: Baran
authors: B
authors: Erman
authors: İlhan
authors: İ
authors: Tezcan
authors: Erdem
authors: E
authors: Karabulut
mesh_terms: D015921:Dental Implants; D005260:Female; D005881:Gingiva / Q000637:transplantation*; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis; D007633:Keratins / Q000276:immunology / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011861:Radiography, Dental
chemical_list: D015921:Dental Implants; D053583:Interleukin-1beta; D007633:Keratins
keywords: clinical study; implant; inflammation; radiographs; soft tissue grafting