Impact of Keratinized Mucosa Width and Mucosal Thickness on Implant Outcomes and Brushing Discomfort: A 25-Year Cohort Study

IF 8.3 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology Pub Date : 2026-10-12 Epub Date: 2026-08-06 DOI:10.1111/jcpe.70187

Emilio Couso-Queiruga, Clemens Raabe, Andrea Roccuzzo, Giovanni E. Salvi, Manrique Fonseca, Vivianne Chappuis

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引用次数: 0

Abstract

Objective

To assess the impact of keratinized mucosa width (KMW) and mucosal thickness (MT) on peri-implant conditions over 25 years in patients with adequate oral hygiene enrolled in regular supportive peri-implant care.

Methods

Partially edentulous patients rehabilitated with tissue-level implants were clinically and radiographically evaluated by calibrated examiners. Patient-reported brushing discomfort was recorded, and associations with variables of interest were analysed.

Results

A total of 149 patients, 235 implants, with a mean follow-up of 25.4 ± 3 years, were included. Peri-implantitis prevalence was 11.1%, 0% and 7.1% in the 0-mm, < 2-mm and ≥ 2-mm KMW groups, respectively (p = 0.98). Sites with 0 mm KMW showed significantly greater crestal bone loss (CBL) than < 2 mm (−0.28 mm) and ≥ 2 mm (−0.40 mm) (p = 0.01). Absence of KMW was associated with an increased risk of peri-implant soft-tissue dehiscence (PSTD) and implant platform visibility (p ≤ 0.01). No significant differences were observed for probing depth (PD), bleeding on probing (BOP), plaque index or peri-implant diseases (p > 0.05). MT was not associated with CBL, PD, BOP, suppuration on probing (SOP) or peri-implant diseases (p > 0.05). Thin MT (< 2 mm) was linked to increased PSTD (p = 0.005), greater implant platform visibility (p = 0.04) and lower plaque index (p = 0.01). Brushing discomfort was reported in 11.4% of sites with 0 mm KMW, compared with 3.4% and 2.4% in the < 2 mm and ≥ 2 mm groups, respectively, with no significant associations across KMW or MT groups (p > 0.05).

Conclusions

KMW was associated with long-term peri-implant tissue stability, whereas thin MT was primarily associated with an increased risk of PSTD. Neither KMW nor MT was significantly associated with long-term brushing discomfort.

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角化的粘膜宽度和厚度对种植体结果和刷牙不适的影响：一项25年的队列研究

目的评估角化粘膜宽度（KMW）和粘膜厚度（MT）对25年来定期支持种植期护理的口腔卫生良好的患者种植期状况的影响。方法对采用组织水平种植体修复的部分无牙患者进行临床和影像学评价。记录患者报告的刷牙不适，并分析与感兴趣变量的关联。结果共纳入149例患者，种植体235枚，平均随访25.4±3年。在0‐mm、2‐mm和≥2‐mm KMW组中，种植体周围炎患病率分别为11.1%、0%和7.1% （p = 0.98）。KMW为0 mm的牙冠骨损失（CBL）明显大于KMW为2 mm （- 0.28 mm）和KMW≥2 mm （- 0.40 mm）的牙冠骨损失（CBL）（p = 0.01）。KMW缺失与种植体周围软组织开裂（PSTD）和种植体平台可见性风险增加相关（p≤0.01）。在探查深度（PD）、探查出血（BOP）、斑块指数或种植体周围疾病方面，两组无显著差异（p > 0.05）。MT与CBL、PD、BOP、探查时化脓（SOP）或种植体周围疾病无关（p > 0.05）。薄MT （2mm）与PSTD增加（p = 0.005）、种植体平台可见度增加（p = 0.04）和斑块指数降低（p = 0.01）有关。0 mm KMW组中有11.4%的部位出现刷牙不适，而2 mm和≥2 mm组分别为3.4%和2.4%，KMW组和MT组之间无显著关联（p > 0.05）。结论：KMW与种植体周围长期组织稳定性相关，而薄MT主要与PSTD风险增加相关。KMW和MT与长期刷牙不适均无显著相关性。

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.