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<p>Mucogingival Considerations around Teeth and Implants<br>Lieutenant Commander Matthew B. B. Miller, DC, USN and Captain Matthew J. Gramkee, DC, USN<br><br>Introduction<br>Teeth and dental implants are surrounded by oral epithelium.<br>This epithelium may be keratinized gingiva or mucosa.<br>Multiple studies have demonstrated that the tissue type<br>at this soft-tissue interface can have a profound impact on<br>the health and long-term prognosis of both teeth and implants.<br>Areas of adequate keratinized gingiva are more<br>resistant to chronic inflammation, less likely to have recession<br>and more comfortable to cleanse.  Oral mucosa<br>poorly adapts around dental implants and provides a poor<br>seal, especially in areas with frenal attachments, when<br>compared to keratinzed gingiva. Also, the light pink color<br>typically associated with keratinized gingiva produces a<br>more aesthetic result in areas of high visibility. Areas which<br>lack adequate keratinized tissue are said to have a mucogingival<br>defect and are annotated via an asterisk in the Periodontal<br>Screening and Recording (PSR) index. Once identified,<br>the patient can then be referred to a periodontist for<br>evaluation and potential correction of the defect.<br><br>The purpose of this clinical update is to outline surgical<br>considerations and available materials and techniques to<br>manage mucogingival defects around teeth and dental implants.
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<br>Subjects: Dental Implants;  Epithelium ; Gingiva;  Inflammation; Mouth Mucosa; Mucous Membrane</div>
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U.S. Navy. Naval Postgraduate Dental School</div>
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