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The aim of this prospective 4-years-study on partially edentulous patients with a treated generalized aggressive periodontitis (GAP) and implants was the examination of coherence between keratinized mucosa and clinical parameters.
35 patients (15 m, 20 f) treated for generalized aggressive periodontitis (GAP) and 18 healthy control patients (6 m, 12 f) participated in this study. The patients received 179 implants which showed at least 2mm of keratinized mucosa (KM) at the point of implant exposure. The clinical examination of the implants and the teeth was continued at three 3-month intervals for a total of 4 years.
It could be shown that implants of the patients with GAP show a significant lower recession than the implants of the control group patients. Furthermore, GAP-patients have shown a significantly lower recession on implants than on teeth in this group. Probing depth and bleeding on probing (BNS) was significantly higher on implants than on teeth. Comparing both patient groups, control patients had a significantly lower BNS.
The KM on implants was significantly lower than the attached gingiva (AG) on teeth in both patient groups. GAP patients showed a significantly lower KM on implants. Comparing the maxilla and mandibula, both teeth and implants in the maxilla had a significantly wider KM and AG. During the observational period, 55 implants (30.7%) of both patient groups showed a KM less than 2mm 2 years after insertion of the suprastructure. In particular, in the anterior mandibula of GAP patients, 56.25% of the implants showed a KM less than 2mm. The clinical parameters indicated no correlation with the width of the keratinized mucosa. Only the KM showed a positive correlation with the probing depth.
The results of this study indicate that the applied exposure technique without connective tissue or epithelial transplantation leads to a decline in KM on implants in the anterior regions. Implants in the anterior mandibula seem to be susceptible to recessions of the KM. Further studies are needed to show if other exposure techniques, such as rectangular or apical flaps, can avoid the decline in KM.