Biologic Width and Morphologic Characteristics of Soft Tissues Around Immediately Loaded Implants: Studies Performed on Human Autopsy Specimens

Abstract

Esthetics and the health of oral implants are based upon the soft tissue reaction and biologic width (BW). Twelve dental implants were placed in the maxilla and mandible of a patient who smoked. Permanent standard abutments and temporary restorations were immediately fixed in place during the surgery stage. The definitive restorations were placed 4 months after loading without removal of the original abutments. After 10 months, the patient died, and the implants were removed en block and processed for histology. The BW in the maxilla was 6.5 +/- 2.5 mm, whereas in the mandible, it was 4.8 +/- 1.3 mm (P = 0.017). The sulcular epithelium (SE) in the maxilla was 2.7 +/- 0.8 mm, whereas in the mandible, it was 1.7 +/- 0.4 mm (P <0.001). The junctional epithelium (JE) in the maxilla was 1.3 +/- 0.4 mm, whereas in the mandible, it was 1.5 +/- 0.5 mm (P = 0.164). The connective tissue (CT) in the maxilla was 2.5 +/- 1.3 mm, whereas in the mandible, it was 1.6 +/- 0.4 mm (P = 0.006). In the maxillary bone, the BW, SE, and CT were significantly longer than in the mandible, whereas for the JE, no statistically significant difference was observed. The soft tissue organization around dental implants was different for upper and lower jawbones.