Peri‐Implant Soft Tissue Deformities in the Anterior Maxilla: A Cross‐Sectional Study
Emilio Couso‐Queiruga, Matteo Leoncini, Sophia E. Vollath, Gustavo Avila‐Ortiz, Ignacio Sanz‐Martin, Vivianne Chappuis, Manrique Fonseca, Clemens RaabeABSTRACT
Background
This study aimed to evaluate the prevalence of peri‐implant soft tissue deformities, including dehiscences (PSTDs) and deficiencies, around bone‐level (BL) and tissue‐level (TL) implants in the anterior maxilla, assess associated variables, and patient‐reported outcomes (PROs).
Methods
Adults with implant‐supported prostheses (ISPs) in the anterior maxilla were recruited. Clinical and digital assessments were performed, and related variables were analyzed.
Results
A total of 205 ISPs in 193 patients were evaluated. Mean follow‐up after implant placement was 11.3 ± 1.4 years. PSTD prevalence was comparable between BL and TL implants (88.8% vs. 94.4%; p = 0.19), or when PSTD ≥ 1 mm (23.9% vs. 22.5%; p = 0.97). Similarly, 99.25% and 100% of BL and TL showed deformities, p = 1.00. Prevalence of prosthetic interface/abutment (12.7% vs. 2.5%) and implant shoulder exposure (4.2% vs. 0%), and overcontoured ISP (35.2% vs. 12.7%) was significantly higher in TL implants ( p < 0.01). Greater papilla dimensions and lower volume deficiency (90.3% vs. 98.6%; p < 0.01) were observed around BL implants, while mucosal discoloration was similar between groups (16.4% vs. 15.5%; p > 0.05). Greater PSTD depth was associated with older age, reduced keratinized mucosa width (< 2 mm), wider implant diameter, prosthetic overcontouring, lower mucosal volume, and papilla deficiencies ( p < 0.05). Wider prosthetic emergence angles were associated with reduced papilla dimensions ( p < 0.05). Thin mucosa (< 2 mm) was associated with grayish mucosal discoloration (OR = 2.79). Despite these findings, OHIP‐14 scores were low, and PROs were high, with no significant differences between groups.
Conclusions
Prevalence of peri‐implant soft tissue deformities in the anterior maxilla is high irrespective of implant type and is associated with age, soft tissue phenotype, mucosal volume, papilla deficiencies, wider implant diameters, and prosthetic overcontouring. However, this does not seem to have a measurable impact on patient perception.