Influence of Peri-Implant Soft Tissue Condition and Plaque Accumulation on Peri-Implantitis: a Systematic Review.
OBJECTIVE
To systematically examine influence of soft tissue condition and plaque accumulation around dental implants on peri-implantitis development.


METHODS
An electronic literature search was conducted of two databases - MEDLINE (Ovid) and EMBASE from 2011 to 2016. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported soft tissue condition or plaque accumulation influence on peri-implantitis development were included. The resulting articles were independently subjected to clear inclusion and exclusion criteria by two reviewers as follows.


RESULTS
The search resulted in 8 articles meeting the inclusion criteria. These studies reported gingival index, plaque index, pocket depth, bleeding on probing/modified bleeding index for sites with "adequate" (≥ 2 mm) and "inadequate" (< 2 mm) width of keratinized mucosa. Results demonstrated that the amount of keratinized mucosa has little influence on soft-tissue inflammation in the presence of good oral hygiene. However, suboptimal oral hygiene due to difficulty in access for plaque control in the areas of minimal keratinized mucosa may lead to greater tissue damage.


CONCLUSIONS
In cases with insufficient keratinized gingiva in the vicinity of implants, the insufficiency does not necessarily mediate adverse effects on the hygiene management and soft tissue health condition. Nonetheless, the risk of the increase of gingival index, plaque index, pocket depth, bleeding on probing/modified bleeding index is present. Therefore, the presence of an appropriate amount of keratinized gingiva is required.
Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania.
Mindaugas
M
Pranskunas
Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania.
Lukas
L
Poskevicius
Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania.
Gintaras
G
Juodzbalys
Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania.
Ricardas
R
Kubilius
Department of Oral and Maxillofacial Surgery and Oral Medicine Faculty of Odontology, Malmö University Sweden.
Ryo
R
Jimbo
dental implants; dental plaque; gingiva; peri-implantitis; risk factors