Analyzing the effects of adequate/inadequate keratinized mucosa width on periimplant clinical parameters and periimplant crevicular fluid TNF-α levels

In this study, the clinical and immunological effects of adequate/inadequate keratinized mucosa width (KMW) on periimplant tissues were investigated by evaluating periimplant clinical parameters and periimplant crevicular fluid (PİCF) Tumor Nekrozis Factor-α (TNF-α) levels. Sixty seven dental implants (DI) were included in this study and DI were grouped according to the present KMW. DI with inadequate KMW were the free gingival graft (FGG) group and the group without FGG (maintenance group), while DI with adequate KMW were the control group. Clinical parameters and PİCF TNF-α levels were measured at baseline (one month after Phase 2 surgery), 2 and 6 months following surgery in the FGG group and at baseline and 6 months in the other groups. Clinical parameters were significantly higher in the FGG group compared to other groups [except for pocket depth (PD) and KMW] at baseline. In the FGG group; significant clinical improvements compared to baseline were observed at 2th month and 6th month and these improvements were more evident than in the maintenance group, although no significant differences were found from controls. All clinical parameters decreased in the FGG group (except for KMW), while only PD decreased in other groups at the 6th month. Furthermore, 6th month KMW was higher in the FGG group than in the other groups. PİCF TNF-α levels were higher in the FGG group than in the other groups and there were no differences between controls and the maintenance group at baseline. PİCF TNF-α levels in the FGG group decreased more than the other groups, however no significant differences were found among the groups at the 6thmonth. Although the need for KMW remains controversial in the long-term success of dental implants, results of this study indicated that FGG is an ideal treatment approach and that adequate KMW has beneficial effects on periimplant health.