Stability of Re-established Peri-implant Keratinized Mucosa in the Posterior Mandible over 20 years of Follow-up: A Report of Three Cases

Won-Bae Park; Kitichai Janaphan; Seung-Il Shin; Hyun-Chang Lim

doi:10.32542/implantology.2025008

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2025 Vol.29, Issue 2 Preview Page Next Page

Clinical or Case Report

Stability of Re-established Peri-implant Keratinized Mucosa in the Posterior Mandible over 20 years of Follow-up: A Report of Three Cases

30 June 2025. pp. 80-88

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Abstract

Several studies have suggested that peri-implant keratinized mucosa (PIKM) is related to peri-implant health. Thus, PIKM augmentation, such as free gingival grafting (FGG), is often performed to re-establish the keratinized tissue zone. Implant sites may influence the long-term stability of the re-established PIKM; however, relevant data are insufficient. In three patients, three implants were placed in areas with missing first and second mandibular molars. To create the PIKM zone, an FGG was used. During the follow-up (≥20 years), the re-established PIKM at the distal site in the posterior mandible showed greater reduction than at the mesial site, indicating site-specific stability characteristics. Some implants present with unfavorable bone remodeling and peri-implant diseases, and these conditions seem to contribute to PIKM stability by forming unattached parts of the PIKM. The findings of this study should be verified in a larger patient population with healthier conditions.

Keywords

Autologous transplants

Dental implants

Gingiva

Oral mucosa

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