Soft tissue augmentation for prevention and therapy of peri-implant infections

The success of contemporary implant therapy is no longer defined by implant survival but rather by the maintenance of peri-implant tissue health, based on stable peri-implant soft-tissue dimensions, low inflammatory indices, stable marginal bone levels and esthetic appearance. Peri-implant soft-tissue structures have, therefore, become a topic of interest due to their relevance in preserving peri-implant tissue and stability. The existing clinical data points to relevant role of keratinized mucosa (KM) in maintaining peri-implant tissue stability and health. If the absence or presence of KM < 2 mm coincides with pathological changes in the peri-implant mucosa, surgical interventions aimed at increasing the width of peri-implant KM should be considered. The apically positioned flap along with the free gingival grafts constitutes the most predictable technique for establishing peri-implant KM. Substitute materials of xenogeneic origin have demonstrated promising results and may be used as an alternative to autogenous tissues. Soft tissue thickness plays a crucial role in the stability of marginal bone loss and the maintenance of peri-implant tissue health. Although connective tissue graft remains the standard for increasing mucosa thickness, soft tissue substitutes constitute a viable alternative.