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In regard to a critical discussion on the topic of “keratinized gingiva surrounding the implant” and its relation to important in the former, while careful prosthetic design is paramount in the latter. In the “Scandinavian Approach”, “necessity” is the basis of the intervention principle; however in the “American Approach”, the subjective decisions of the practicing clinician seem to play a larger role on the extent to which treatment is conducted. The difference between the two approaches is the criteria for clinical intervention which can be categorized in terms of what should be done, what can be done, what does not have to be done, and what should not be done.

Critical discussion with regard to two articles: “Keratinized tissue around implants” by Matsui and “Peri-implant prosthesis” by Hirooka