Do we need keratinized mucosa for a healthy peri-implant soft tissue?

The presence of keratinized mucosa plays a fundamental role in peri-implant soft tissue health. This study assessed the impact of the width of keratinized mucosa (WKM) on peri-implant soft tissue parameters. A cross-sectional study was conducted on 110 bone-level implants in 36 patients. A minimum of 6 months had passed since the loading of implants, and the patients had at least 1 implant in 1 quadrant at the molar or premolar site restored with a single crown or fixed partial denture. The health of peri-implant soft tissue was assessed with a modified bleeding index (MBI), modified plaque index (MPI), and modified gingival index (MGI). Probing depth (PD), gingival recession (GR), and WKM were also measured. History of smoking and oral hygiene methods were recorded. A significant inverse correlation existed between WKM and the parameters MBI, MPI, MGI, and GR (P < 0.05). Values of MBI, MPI, MGI, and GR were significantly lower in areas with WKM ≥ 2 mm and higher in areas with WKM < 2 mm (P < 0.05). The WKM was greatest in subjects using the vibratory toothbrushing technique and narrowest in those using the horizontal toothbrushing technique (P < 0.05). The mean WKM was significantly greater in smokers than in nonsmokers (P < 0.05). Results of this study indicate that an association exists between WKM and peri-implant soft tissue health. A minimum of 2 mm of keratinized mucosa around implants is recommended.