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Keratinized Mucosa Width and Peri-Implant Health: Clinical Associations to Inform Soft Tissue Evaluation
Kavitha Parthasarathy1, Josef Huang1, Didem Ozdemir Ozenen2
1Department of Periodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA, pacific.edu.
Objective:
The clinical necessity of keratinized mucosa (KM) around dental implants remains debated. This study examines whether KM width influences peri-implant soft tissue health and informs decisions for soft tissue augmentation.
Methods:
In this cross-sectional study, 56 adults with 101 dental implants in function for at least 12 months were examined. Implants were categorized by midfacial KM width as ≥2 mm (n = 50) or <2 mm (n = 51). Clinical parameters included plaque index (PI), bleeding on probing (BOP), probing depth (PD), and mucosal recession (MR), analyzed using mixed-effects models and generalized estimating equations (GEE) to account for multiple implants per patient.
Results:
After accounting for patient-level clustering, implants with <2 mm KM demonstrated higher BOP (45.1% vs. 26.0%; OR = 0.39, 95% CI [0.18-0.88], p = 0.023), greater plaque accumulation (0.90 vs. 0.56; β = -0.29, 95% CI [-0.53, -0.05], p = 0.019), and increased MR (0.12 mm vs. 0.00 mm; β = -0.12, 95% CI [-0.21, -0.03], p = 0.009) compared with those having ≥2 mm KM. No significant differences in PD were observed.
Conclusion:
A KM width of at least 2 mm is associated with reduced peri-implant inflammation and recession. These findings suggest that reduced KM width may be associated with adverse peri-implant parameters and could serve as a clinical consideration during assessment.
Practical Implications:
Adequate KM may reduce peri-implant inflammation and recession. Evaluating KM width during periodontal maintenance visits may help identify sites warranting further soft tissue evaluation by a periodontist.
