Developing Keratinized Mucosa Around Nonsubmerged Dental Implants. Part II: The Use of Non-Vascularized Soft-Tissue Grafts

The original protocol for the placement of endosseous dental implants required a fully submerged positioning beneath the oral soft tissues. This method necessitated a second surgical procedure to facilitate abutment connection and subsequent restoration (Branemark, 1985). It has been observed that the second surgical procedure could reduce or eliminate the amount of keratinized mucosa in the peri-implant region (Han, 1995; Tinti, 1995). This finding is important to note as it has been postulated that the establishment of a circumferential sealing effect by a dense connective tissue collar at the site of implant penetration into a contaminated environment of the oral cavity was a prerequisite for long-term success of dental implants (Schroeder, 1981; McKinney, 1988). Warrer et al (1995) found that the absence of keratinized mucosa around dental implants increases the susceptibility of the peri-implant region to plaque-induced destruction. An endosseous dental implant utilizing Developing Keratinized Mucosa Around Nonsubmerged Dental Implants. Part II: The Use of Non-Vascularized Soft-Tissue Grafts