Peri-Implant Wound Healing and Clinical Outcomes

This review provides an in-depth evaluation of the existing information on peri-implant wound healing basics with a specific focus on local and systemic determinants affecting short and long-term clinical outcomes.

Peri-implant wound healing has been heavily studied in relation to biocompatibility of biomaterials and various surgical techniques for predictable and stable osseointegration. Short-term outcomes have been explored as a response to immediate, early and delayed implant placement and/or mechanical loading while long-term stability has been investigated as a response of time, restorative design and well-established risk factors such as periodontitis and smoking. It has been also reported that peri-implant bone remodeling is a continuous phenomenon, and several ill-described local factors may differentially affect implant fixture and bone interface.

As research presents better evidence on implant soft tissue interface, we now understand that established peri-implant sulcus consists of a modified mucosal seal/ soft tissue attachment with short junctional epithelium, significant fibrotic connective tissue and limited wound healing capacity. In addition, long-term response of the soft tissue against titanium alloy as a transmucosal device within oral cavity has raised significant challenges negatively affecting success of implant supported dental restorations.