Peri-Implant Conditions: Soft- and Hard-Tissue Deficiencies-Peri-Implant Conditions: Soft- and Hard-Tissue Deficiencies

Video Transcription

Video Summary

Dr. Sarah Ringdahl’s webinar reviewed peri-implant health, disease, and soft- and hard-tissue deficiencies before and after implant placement.<br /><br />Healthy implants may have light, brief bleeding on gentle probing and probing depths of about 5 mm or less; depth alone does not diagnose disease. Peri-implant mucositis involves inflammation without supporting bone loss and is generally reversible. Peri-implantitis includes inflammation and progressive bone loss. Tissue deficiencies, by contrast, are typically developmental, traumatic, or treatment-related rather than plaque-caused.<br /><br />For soft-tissue deficiencies, free gingival grafts can increase keratinized tissue, while connective-tissue grafts can improve tissue thickness, volume, and aesthetics. Grafts may be used before or after implant placement, with the tuberosity often preferred as a connective-tissue donor site.<br /><br />Hard-tissue deficiencies include horizontal, vertical, combined ridge defects, and sinus pneumatization. Ridge preservation can reduce post-extraction bone loss. More extensive augmentation may use particulate grafts, membranes, tenting screws, block grafts, or custom devices. Predictability depends on the PASS principles: primary closure, angiogenesis, wound stability, and space maintenance.<br /><br />Case examples emphasized careful planning, preserving papillae and soft tissue, staging procedures when appropriate, and matching treatment to the defect and patient’s needs. Not every deficiency requires treatment if the implant is healthy and the patient has no symptoms or aesthetic concerns.<br /><br />The central message was prevention: perform minimally traumatic extractions, preserve ridges, augment tissues when indicated, and place implants only where the available bone and soft tissue support long-term health and cleansability.

Keywords

peri-implant health

peri-implant mucositis

peri-implantitis

soft-tissue deficiencies

hard-tissue deficiencies

free gingival graft

connective-tissue graft

ridge preservation

ridge augmentation

sinus pneumatization

PASS principles

implant placement