Soft-Tissue Management as Part of the Surgical Treatment of Periimplantitis: A Narrative Review

Conclusions:
The limited available data seem to indicate that the best outcome to improve the width of KAM, and the bleeding and plaque scores, as well as to maintain the periimplant marginal bone level is the use of an apically positioned flap combined with a free gingival graft in nondiseased periimplant sites. However, at present, it is unknown: (a) to what extent soft-tissue grafting may additionally improve the outcomes after surgical (resective or regenerative) treatment of periimplantitis compared with the same approaches without soft-tissue grafting, and (b) if considered, when should soft-tissue grafting be performed (eg, before or during surgical treatment of periimplantitis).
Clinical Recommendations:
Both soft-tissue resective and regenerative approaches may lead to successful outcomes depending on the clinical indication and defect location. However, the selection of one or another surgical approach should be based on defect type (eg, intrabony and suprabony) and location (esthetic or nonesthetic areas). The presence of an adequate width and thickness of KAM may facilitate soft-tissue (flap) management. In patients with a thin phenotype or lack of an adequate width of KAM, soft-tissue grafting may improve the clinical outcomes.

Source: Implant Dentistry - March 26, 2019 Category: Dentistry Tags: Consensus Source Type: research