Inter-abutment and peri-abutment mucosal enlargement with mandibular implant overdentures

A variety of terms have been used to describe changes in the oral mucosa around abutments underneath fixed and removable implant prostheses such as mucosal inflammation, peri-implant mucosal hyperplasia, gingival hyperplasia, hyperplastic tissue, mucosal proliferation, proliferative gingivitis and peri-implant mucositis. Although such terms have become part of the evidence-based literature, there is no histological evidence to support the descriptive terminology used by authors. The use of the alternative term mucosal enlargement for clinical observations underneath mandibular implant overdentures is proposed. Prospective and retrospective reports have failed to use similar criteria to measure periodontal parameters in relation to these mucosal changes, both in keratinized or non-keratinized tissues. Therapeutic remedies for mucosal enlargement are dictated by authors' opinions on the possible aetiology. This literature review, coupled with clinical observations during a 5-year prospective study, prompts this proposal of the term mucosal enlargement underneath splinted and unsplinted mandibular implant overdentures.