title: Is the presence of keratinized mucosa associated with periimplant tissue health? A clinical cross-sectional analysis.
abstract: BACKGROUND
  Long-term data concerning the impact of missing keratinized mucosa (KM) on periimplant tissue health are rare. The importance of KM for implant success remains unclear.
  
  
  METHODS
  Two hundred eleven patients with 967 dental implants were analyzed up to 15 years after implant placement. Implants were divided into two groups: no keratinized mucosa (NKM) and KM. Evaluated parameters were plaque index (mAPI), bleeding index (mSBI), bleeding on probing (BOP), probing depth (PD), width of KM, and radiographic vertical bone level.
  
  
  RESULTS
  mAPI, mSBI, and BOP were significantly higher for the NKM group. Implants of both groups showed no significant difference in PD and vertical bone level. Of the implants in the posterior regions (n = 261), 40.3% (regions 37 to 34, 44 to 47, 27 to 24, 17 to 14) showed NKM, whereas 30.4% of the implants in the anterior regions (regions 13 to 23; regions 33 to 43) presented NKM (n = 97).
  
  
  CONCLUSIONS
  Results indicate that the presence of KM has a positive effect on periimplant tissue health, but does not seem to have an influence on the periimplant bone level.
authors.affiliation: Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, D-79106, Freiburg, Germany.
authors.forename: Catharina
authors.initials: C
authors.lastname: Ladwein
authors.affiliation: Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, D-79106, Freiburg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmelzeisen
authors.affiliation: Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, D-79106, Freiburg, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Nelson
authors.affiliation: Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, D-79106, Freiburg, Germany.
authors.forename: Tabea Viktoria
authors.initials: TV
authors.lastname: Fluegge
authors.affiliation: Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, D-79106, Freiburg, Germany. tobias.fretwurst@uniklinik-freiburg.de.
authors.forename: Tobias
authors.identifier: http://orcid.org/0000-0003-4769-7610
authors.initials: T
authors.lastname: Fretwurst
keywords: Attached gingiva; Dental implants; Implantology; Keratinized mucosa; Periimplantitis