Relationship between peri-implant soft tissue characteristics and peri-implant health and mucositis: a cross-sectional study

Abstract

This study aimed to evaluate the effects of keratinized tissue width, gingival thickness, and phenotype on peri-implant tissue health and to investigate their association with peri-implant mucositis. A total of 316 implants (165 individuals) were included in the study. Clinical and periodontal parameters, including plaque and gingival indices, probing pocket depth, bleeding on probing, gingival recession, and clinical attachment level, were recorded. The keratinized tissue width, gingival thickness, and gingival phenotype were assessed and compared between the peri-implant health and peri-implant mucositis groups. Binary logistic regression analysis was performed to identify predictors of peri-implant mucositis and gingival characteristics. The keratinized tissue width did not significantly differ between the peri-implant health and mucositis groups (p > .05). The gingival thickness and phenotype were significantly different (p < .05 and p > .05, respectively), but the effect size for gingival thickness was small (Cohen’s d = 0.27), indicating limited clinical importance. Logistic regression showed that plaque, gingival indices, gingival thickness, and gingival phenotype predicted peri-implant mucositis. Increased gingival thickness, plaque, and gingival indices were associated with a higher risk of mucositis, whereas a thin gingival phenotype was associated with a reduced risk. Attachment level was the only significant predictor of keratinized tissue width > 2 mm, whereas no variables significantly predicted gingival thickness. Although gingival thickness and phenotype were statistically associated with peri-implant mucositis, their clinical contribution was limited. Plaque accumulation and gingival inflammation remained the strongest predictors of peri-implant disease.