title: Soft-tissue grafting for peri-implantitis-a treatment option in case of unsuitable skeletal basic morphology of the alveolar bone and lack of keratinized mucosa: a retrospective clinical cohort study.
abstract: BACKGROUND
  This retrospective study evaluated soft-tissue grafting as a surgical treatment option for peri-implantitis in case of unsuitable basic skeletal morphology of the alveolar bone and lack of keratinized mucosa.
  
  
  METHODS
  Twenty-eight patients (21 females, 7 males, at a mean age 59.4 years) were included with a total of 54 implants. All implants showed peri-implantitis and attached keratinized buccal mucosa of ≤2 mm. A surgical procedure of soft-tissue grafting (STG) was made by inserting an inlay and inlay-onlay transplant. Clinical investigations were made prior to the STG (baseline) and after 9-180 months (Ø 43 months) including the following parameters: soft-tissue biotype, skeletal basic morphology of the alveolar bone, width of the peri-implant keratinized mucosa (KM), mobility of the KM, pocket probing depth (PPD), and bleeding on probing (BOP).
  
  
  RESULTS
  Nearly all patients showed a thin soft-tissue biotype. The analysis of the skeletal basic morphology of the alveolar bone revealed a narrow apical base in 18 patients, middle base in 7 patients, and broad base in 3 patients. Width of the KM increased significantly (p < 0.01) from 0.4 ± 0,5 mm to 4.3 ± 1.5 mm after STG and PPD was significantly (p < 0,01) reduced from 6.3 ± 2,3 mm to 4.1 ± 1.9 mm. A significant reduction (p < 0.01) in BOP was recorded. All patients reported a clinical improvement of the inflammatory symptoms at follow-up.
  
  
  CONCLUSIONS
  The results of this study showed that the STG can be applied successfully as a surgical treatment of peri-implantitis. It remains unclear whether soft-tissue biotype or the skeletal basic morphology of the alveolar bone affects the outcome of this surgical treatment.
authors.affiliation: School of Dental Medicine, Section of Experimental Orofacial Medicine, Philipps University, Georg-Voigt-Str. 3, 35039, Marburg, Germany.|Private Practice for Oral Surgery and Implantology, ECDI Center, Brahmsst. 11, 14193, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Stiller
authors.affiliation: School of Dental Medicine, Department of Prosthodontics, Philipps University, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Mengel
authors.affiliation: Practice of Oral and Maxillofacial Surgery, ECDI Center, Königsallee 68, 40212, Düsseldorf, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Becher
authors.affiliation: Clinic ABC Bogen, ECDI Center, ABC Strasse 19, 20354, Hamburg, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Brinkmann
authors.affiliation: School of Dental Medicine, Department of Prosthodontics, Philipps University, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Peleska
authors.affiliation: Department of Postgraduate Education - Master of Oral Implantology, Center for Oral and Maxillofacial Surgery, Johann Wolfgang Goethe University Frankfurt, Theodor-Stern-Kai 17, Frankfurt, 60577, Germany. kluk@implant-consult.de.|Private Practice for Oral Surgery and Implantology, ECDI Center, Brahmsst. 11, 14193, Berlin, Germany. kluk@implant-consult.de.
authors.forename: Esther
authors.initials: E
authors.lastname: Kluk
keywords: Apical skeletal basis; Keratinized mucosa; Peri-implantitis treatment; Soft-tissue grafts