Critical soft-tissue dimensions with dental implants and treatment concepts

Dental implants have proven to be a successful treatment option in fully and partially edentulous patients, rendering long-term functional and esthetic outcomes. Various factors are crucial for predictable long-term peri-implant tissue stability, including the biologic width; the papilla height and the mucosal soft-tissue level; the amounts of soft-tissue volume and keratinized tissue; and the biotype of the mucosa. The biotype of the mucosa is congenitally set, whereas many other parameters can, to some extent, be influenced by the treatment itself. Clinically, the choice of the dental implant and the position in a vertical and horizontal direction can substantially influence the establishment of the biologic width and subsequently the location of the buccal mucosa and the papilla height. Current treatment concepts predominantly focus on providing optimized peri-implant soft-tissue conditions before the start of the prosthetic phase and insertion of the final reconstruction. These include refined surgical techniques and the use of materials from autogenous and xenogenic origins to augment soft-tissue volume and keratinized tissue around dental implants, thereby mimicking the appearance of natural teeth.