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Periodontologist's viewpoint inclusive of soft tissues around implants
Author(s) -
Van Steenberghe D,
Michiels K
Publication year - 2006
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/j.1601-0825.2006.01306_4.x
Subject(s) - soft tissue , alveolar mucosa , implant , pathology , fibrosis , medicine , oral mucosa , junctional epithelium , stroma , dental alveolus , dentistry , epithelium , immunohistochemistry , surgery
Integuments play a key role for the integrity of the bodily tissues. Both teeth and oral implants pierce the gingiva or alveolar mucosa with an interface acting as a relative seal. The epithelia adhering by means a basal membrane to either the implant or a tooth are not keratinized. They both contain laminin‐5 with a similar structural relationship. The cytokeratins are strikingly similar in both instances. Il‐1 beta and TGF‐beta 1, when overexpressed jeopardize the soft tissue healing and lead to fibrosis. Subepithelial bullous diseases may thus be a relative contra‐indication. Although soft tissue innervation has been described, Merkel cells seem to be absent around artificial abutments. The subepithelial vascular supply with its characteristic loops is also found in both instances. Furthermore the stroma and the outflow crevicular fluid are strikingly similar from a quantitative and compositional viewpoint. When a biofilm accumulates on a tooth or an implant, the surrounding soft tissues demonstrate an inflammatory reaction, which cannot be distinguished from eachother. This will interact with the healing of blistering diseases as observed with the natural dentition. The non‐plaque related pathologies of peri‐implant gingival and alveolar mucosa are hardly documented but some case reports reveal a similar reaction. For example gingival cyclosporin also induces hyperplasia around implants. Few reports provide histological insights on the mucosal pathologies such as lichen planus or pemphigoid. This part of oral pathology merits more attention. At the clinical level periodontologists can meanwhile extrapolate their expertise to the peri‐implant soft tissues.