Keratinized Tissue Grafting May Prevent Peri-implantitis: A Case Series

The necessity of a minimum volume of keratinized tissue around implants to maintain tissue sta-bility remains a matter of debate. This case series aims to showcase the outcomes and long-term maintenance of implants that received soft tissue augmentation. Three cases of stage-two surgery following implant placement were evaluated to determine the amount of keratinized tissue around the implant. Based on the Ono-Nevins classification described herein, treatment was rendered, including keratinized tissue grafting. The cases were followed for 10, 18, and 28 years. Each case demonstrated maintenance of the soft and hard tissue profiles around the implants with no inci-dence of peri-implantitis, as evidenced on clinical examination and periapical radiographs. Soft tis-sue management around implants may play a key role in the long-term maintenance of peri-implant health and prevention of peri-implantitis.