Soft-Tissue Considerations

Michael Tischler, DDS


This month in the Implants Today section, we are focused on dental implant-adjacent soft-tissue considerations. The first thing most clinicians consider for dental implant treatment plans is the bone that is required for support of the dental implant(s). While that is logically the first consideration, the biological interrelationship between the hard and soft tissues that support a dental implant must be considered with any dental implant treatment plan. The vascularity associated with a dental implant is connected and nurturing to both the hard and soft tissue. The health of both hard- and soft-tissue cellular structures supports a dental implant.

The soft tissue around a dental implant can help protect a dental implant from debris and bacteria entering the sulcus around it. The degree of protection that the soft tissue offers is related to the amount of keratinized tissue content present. It is important to note the amount of keratinized tissue available at the surgical site during the treatment planning phase appointment. If there is inadequate keratinized tissue noted, the treatment plan can then include surgical treatment to either augment the tissue with grafting and/or utilize surgical repositioning procedures. These steps should be predetermined so that the patient is apprised of the planned treatment from both the informed consent and financial perspectives.

Besides protection of a dental implant, soft issue has an important role in the aesthetics around an implant, especially in the anterior region. Once again, treatment planning considerations must be made to address any grafting or surgical manipulation that could increase aesthetic results. It is also important to consider that, no matter how attentive a clinician is, post-surgical soft-tissue complications can happen. This could be related to patient host factors and habits, dental implant design-related issues, and more.

This month, Jonathan Waasdorp, DMD, MS, has an excellent article, “Management of Retrograde Peri-implantitis: The Minimally Invasive Tunnel Approach.” This article addresses how to deal with this soft tissue complication. Also, Joseph Massad, DDS; Mahesh Verma, MDS, MBA, PhD; and Swati Ahuja, BDS, MDS, have contributed yet another informative article on the importance of recommending the use of an electric toothbrush to maintain soft-tissue health around dental implants.

If you have any questions or comments about this topic, or any other subject presented in Implants Today, feel free to contact Dr. Tischler at

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